JSON twin: https://www.healthaidb.com/software/experian-coverage-discovery.json
Experian Health
https://www.experian.com/healthcare
Automated insurance-discovery solution that finds previously unknown patient coverage across the revenue cycle to reduce uncompensated care and accelerate reimbursement.
Coverage Discovery (Experian Health) scans pre- and post-service patient records using multiple proprietary data sources (employer records, historical registration, demographic validation and payer data) to identify billable Medicare, Medicaid and commercial coverage, integrate results into revenue-cycle workflows, reduce bad debt and reclassify uncompensated accounts.
yes
1996
US-hosted (contact Experian for global/region hosting options)
P0579
2025-09-07
commercial proprietary
Contact vendor for pricing; enterprise licensing and implementation—trial/contact sales available via Experian Health.
enterprise_quote
product
1.0
{
"company_name": "Experian Health",
"company_url": "https://www.experian.com/healthcare",
"company_offices": [
"United States",
"United Kingdom",
"Canada",
"Australia",
"India",
"Mexico",
"Brazil",
"South Africa",
"Ireland",
"Japan"
],
"company_founding": "1996",
"product_url": "https://www.experian.com/healthcare/products/patient-access-registration/check-patient-health-insurance-lookup",
"categories": [
"administrative",
"revenue cycle management",
"patient access",
"insurance discovery",
"identity management"
],
"market_segment": [
"enterprise",
"hospital & health systems",
"medical groups"
],
"links": [
"https://www.experian.com/healthcare/products/patient-access-registration/check-patient-health-insurance-lookup",
"https://www.experian.com/content/dam/marketing/na/healthcare/brochures/coverage-discovery-product-sheet.pdf",
"https://www.experian.com/content/dam/marketing/na/healthcare/brochures/coverage-discovery.pdf",
"https://www.experian.com/blogs/healthcare/2023/04/coverage-discovery-how-it-works-and-benefits-healthcare-organizations/",
"https://www.experian.com/content/dam/marketing/na/healthcare/case-studies/uc-health-coverage-discovery-case-study.pdf",
"https://www.experian.com/healthcare/products/patient-access-registration/mbi-lookup",
"https://www.experian.com/healthcare/products/patient-access-registration",
"https://www.experian.com/healthcare",
"https://www.linkedin.com/showcase/3561816/",
"https://www.experian.com/blogs/healthcare/"
],
"summary": "Automated insurance-discovery solution that finds previously unknown patient coverage across the revenue cycle to reduce uncompensated care and accelerate reimbursement.",
"description": "Coverage Discovery (Experian Health) scans pre- and post-service patient records using multiple proprietary data sources (employer records, historical registration, demographic validation and payer data) to identify billable Medicare, Medicaid and commercial coverage, integrate results into revenue-cycle workflows, reduce bad debt and reclassify uncompensated accounts.",
"target_users": [
"revenue cycle managers",
"patient access/registration staff",
"billing/collections teams",
"financial clearance teams",
"health system administrators",
"hospital executives"
],
"specialties": [
"hospital medicine",
"medical groups/ambulatory care",
"pharmacy services",
"diagnostics",
"revenue cycle management"
],
"regions_available": [
"United States"
],
"languages_supported": [
"English"
],
"pricing_model": "enterprise_quote",
"pricing_details": "Contact vendor for pricing; enterprise licensing and implementation—trial/contact sales available via Experian Health.",
"license": "commercial proprietary",
"deployment_model": [
"SaaS"
],
"os_platforms": [
"Web"
],
"features": [
"Automated insurance discovery across patient population",
"Self-pay scrubbing pre- and post-service",
"Medicare/Medicaid/private payer identification",
"MBI lookup support",
"Proprietary data source matching (employer, registration, demographics)",
"Batch and real-time scans",
"Revenue recovery/workflow orchestration",
"Reporting and analytics",
"Payer accountability tracking",
"Case management / follow-up for discovered coverage"
],
"optional_modules": [
"MBI Lookup tool",
"Insurance Eligibility Verification",
"Claims management integration (ClaimSource)"
],
"integrations": [
"Experian Health: MBI Lookup",
"Experian Health: Insurance Eligibility Verification",
"Experian Health: ClaimSource",
"Experian Health: Collections Optimization Manager"
],
"data_standards": [],
"api_available": "yes",
"system_requirements": "",
"compliance": [
"HIPAA",
"HITECH",
"SOC 2"
],
"certifications": [],
"security_features": [
"Data encryption (at-rest and in-transit)",
"Role-based access control (RBAC)",
"Single sign-on / SAML",
"Audit logging"
],
"privacy_features": [
"Business Associate Agreement (BAA) available",
"Data minimization / demographic validation"
],
"data_residency": "US-hosted (contact Experian for global/region hosting options)",
"customers": [
"Wooster Community Hospital",
"UCHealth",
"Luminis Health",
"Essentia Health"
],
"user_reviews": [],
"ratings": [],
"support_channels": [
"phone (1-888-661-5657)",
"contact form",
"account management",
"implementation support",
"social media (Twitter, LinkedIn, YouTube)"
],
"training_options": [
"training (Experian Healthcare client training)",
"implementation services",
"account management",
"documentation/resources"
],
"release_year": "",
"integration_partners": [],
"id": "P0579",
"slug": "experian-coverage-discovery",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/experian-coverage-discovery.json"
}
}