experian-claims-management

JSON twin: https://www.healthaidb.com/software/experian-claims-management.json

Company Name

Experian Health

Product URL

https://www.experian.com/healthcare/products/claims-management

Company URL

https://www.experian.com/healthcare/

Categories

Summary

Experian Claims Management is an enterprise claims-clearing and claims-management suite that automates claim editing, submission, status tracking and denial workflows to reduce denials and accelerate reimbursement.

Description

A commercial, integrated claims management platform from Experian Health (includes products such as ClaimSource, Claim Scrubber, Enhanced Claim Status and Denial Workflow Manager). The suite performs automated claim edits and scrubbing, EDI clearinghouse submission, adjudication-status retrieval, denial identification/triage and workflow orchestration to improve clean-claim rates, reduce rework and support payer-policy monitoring and compliance.

Api Available

yes

Certifications

Company Founding

2008

Company Offices

Compliance

Customers

Data Residency

Data Standards

Deployment Model

Features

Id

P0577

Integration Partners

Integrations

Languages Supported

Last Updated

2025-09-07

License

Commercial proprietary

Links

Market Segment

Optional Modules

Os Platforms

Pricing Details

Contact vendor for pricing, enterprise contracts and implementation estimates; demos and trials available by request.

Pricing Model

enterprise_quote

Privacy Features

Ratings

Regions Available

Release Year

Security Features

Specialties

Support Channels

System Requirements

Target Users

Training Options

Type

product

User Reviews

Version

1.0

Canonical JSON

{
  "company_name": "Experian Health",
  "company_url": "https://www.experian.com/healthcare/",
  "company_offices": [
    "United States",
    "United Kingdom",
    "Ireland",
    "Australia",
    "Canada",
    "India",
    "Germany",
    "Brazil",
    "Mexico",
    "South Africa"
  ],
  "company_founding": "2008",
  "product_url": "https://www.experian.com/healthcare/products/claims-management",
  "categories": [
    "revenue cycle management",
    "claims management",
    "denial management",
    "claims scrubber / clearinghouse",
    "analytics",
    "administrative"
  ],
  "market_segment": [
    "enterprise",
    "hospitals & health systems",
    "medical groups"
  ],
  "links": [
    "https://www.experian.com/healthcare/products/claims-management",
    "https://www.experian.com/healthcare/products/claims-management/claimsource-insurance-claims-manager",
    "https://www.experian.com/healthcare/products/claims-management/claim-scrubber",
    "https://www.experian.com/healthcare/products/claims-management/claims-denial-management",
    "https://www.experian.com/healthcare/products/claims-management/accelerate-medical-claim-status-responses",
    "https://www.experian.com/healthcare/about",
    "https://www.experian.com/content/dam/marketing/na/healthcare/brochures/claim-source.pdf",
    "https://www.experian.com/blogs/healthcare/understanding-healthcare-claim-denials-reasons-and-solutions/",
    "https://www.experian.com/blogs/healthcare/state-of-claims-2024-insights-from-survey-findings/",
    "https://www.experian.com/healthcare/client-services/experian-access-login"
  ],
  "summary": "Experian Claims Management is an enterprise claims-clearing and claims-management suite that automates claim editing, submission, status tracking and denial workflows to reduce denials and accelerate reimbursement.",
  "description": "A commercial, integrated claims management platform from Experian Health (includes products such as ClaimSource, Claim Scrubber, Enhanced Claim Status and Denial Workflow Manager). The suite performs automated claim edits and scrubbing, EDI clearinghouse submission, adjudication-status retrieval, denial identification/triage and workflow orchestration to improve clean-claim rates, reduce rework and support payer-policy monitoring and compliance.",
  "target_users": [
    "billing staff",
    "revenue cycle managers",
    "claims analysts",
    "health system administrators",
    "medical group administrators",
    "health IT/integation teams",
    "payers"
  ],
  "specialties": [
    "Revenue cycle management",
    "Medical billing",
    "Claims processing",
    "Denial management",
    "Health information management",
    "Ambulatory care",
    "Hospital / health system"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "enterprise_quote",
  "pricing_details": "Contact vendor for pricing, enterprise contracts and implementation estimates; demos and trials available by request.",
  "license": "Commercial proprietary",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "Claims editing and scrubber (Claim Scrubber / ClaimSource)",
    "Automated claims submission / clearinghouse",
    "Denial workflow automation and management",
    "Enhanced claim status (accelerated adjudication status)",
    "Real-time eligibility and payer policy monitoring",
    "Claims status follow-up and adjudication tracking",
    "Claims analytics and reporting",
    "Automation to reduce manual rework and denials",
    "Integrated product suite for end-to-end claims workflows"
  ],
  "optional_modules": [
    "ClaimSource (insurance claims manager)",
    "Enhanced Claim Status",
    "Denial Workflow Manager",
    "AI Advantage (denial prevention/triage)"
  ],
  "integrations": [
    "Experian Health product suite (ClaimSource, OneSource, Order Manager, Patient Estimates)",
    "Payer networks / clearinghouse connections"
  ],
  "data_standards": [
    "ANSI X12 837 (claims)",
    "ANSI X12 835 (remittance/advice)"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "HITECH",
    "SOC 2"
  ],
  "certifications": [],
  "security_features": [
    "Encryption (in transit and at rest)",
    "Role-based access control (RBAC)",
    "SSO / federated login",
    "Audit logging"
  ],
  "privacy_features": [
    "Business Associate Agreement (BAA) available",
    "Data privacy controls"
  ],
  "data_residency": "",
  "customers": [
    "Community Medical Centers",
    "Summit Medical Group Oregon - BMC",
    "Indiana University / IU Health"
  ],
  "user_reviews": [],
  "ratings": [
    "#1 Best in KLAS 2024 — Claims Management and Clearinghouse (KLAS)",
    "Black Book™ 2024 — Top client-rated Denial & Claims Management (Black Book)"
  ],
  "support_channels": [
    "phone",
    "email",
    "account management",
    "implementation support",
    "documentation"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "implementation training"
  ],
  "release_year": "",
  "integration_partners": [
    "Claim Scrubber (MPV)",
    "ClaimSource® (eCare/ClaimSource)",
    "OneSource® (Passport Health/OneSource)",
    "Order Manager (OrderSmart)",
    "SearchAmerica integrations",
    "MPV integrations",
    "Payer Alerts (MPV)"
  ],
  "id": "P0577",
  "slug": "experian-claims-management",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-09-07",
  "links_json": {
    "self": "https://www.healthaidb.com/software/experian-claims-management.json"
  }
}