JSON twin: https://www.healthaidb.com/software/experian-denial-management.json
Experian Health
https://www.experian.com/healthcare/products/claims-management/claims-denial-management
https://www.experian.com/healthcare
Cloud-based denial management that automates identification, triage, and workflow for denied, suspended, or zero-pay claims to reduce denial rates and accelerate reimbursement.
Experian Denial Management (Denial Workflow Manager) provides automated ingestion of ERA and enhanced claim status, configurable worklists and workflows, analytics and reporting, ANSI and payer reason-code mapping, and optional integration with Experian ClaimSource to prioritize and automate denial follow-up and appeals across the revenue cycle.
yes
1996
P0580
2025-09-07
Commercial proprietary
Contact vendor for pricing and implementation options; enterprise licensing and implementation fees; demos and product sheet available on request.
enterprise_quote
product
1.0
{
"company_name": "Experian Health",
"company_url": "https://www.experian.com/healthcare",
"company_offices": [
"United States",
"United Kingdom",
"Ireland",
"Canada",
"Australia",
"India",
"Brazil",
"Mexico",
"Spain",
"Germany"
],
"company_founding": "1996",
"product_url": "https://www.experian.com/healthcare/products/claims-management/claims-denial-management",
"categories": [
"administrative",
"revenue cycle management",
"claims management",
"denial management",
"analytics"
],
"market_segment": [
"enterprise",
"smb"
],
"links": [
"https://www.experian.com/healthcare/products/claims-management/claims-denial-management",
"https://www.experian.com/content/dam/marketing/na/healthcare/brochures/denials-workflow-manager.pdf",
"https://www.experian.com/healthcare/products/claims-management",
"https://www.experian.com/healthcare/products/claims-management/claimsource-insurance-claims-manager",
"https://www.experian.com/content/dam/marketing/na/healthcare/brochures/enhanced-claim-status.pdf",
"https://www.experian.com/blogs/healthcare/what-is-denial-management-in-healthcare/",
"https://www.experian.com/healthcare/client-services/experian-locations-contact",
"https://www.experian.com/corporate/about-experian"
],
"summary": "Cloud-based denial management that automates identification, triage, and workflow for denied, suspended, or zero-pay claims to reduce denial rates and accelerate reimbursement.",
"description": "Experian Denial Management (Denial Workflow Manager) provides automated ingestion of ERA and enhanced claim status, configurable worklists and workflows, analytics and reporting, ANSI and payer reason-code mapping, and optional integration with Experian ClaimSource to prioritize and automate denial follow-up and appeals across the revenue cycle.",
"target_users": [
"revenue cycle managers",
"claims analysts",
"billing staff",
"denials/appeals teams",
"medical coders",
"billing managers",
"finance/AR teams",
"health IT / integration teams"
],
"specialties": [
"All specialties (hospital and ambulatory)"
],
"regions_available": [
"United States",
"United Kingdom",
"Canada",
"Australia",
"India",
"Brazil",
"Mexico",
"Germany",
"Spain",
"Netherlands",
"Singapore",
"South Africa",
"Japan",
"Italy",
"Sweden",
"Norway",
"New Zealand",
"China",
"Colombia",
"Chile"
],
"languages_supported": [
"English",
"Spanish",
"Portuguese",
"German",
"French",
"Chinese (Simplified)",
"Japanese"
],
"pricing_model": "enterprise_quote",
"pricing_details": "Contact vendor for pricing and implementation options; enterprise licensing and implementation fees; demos and product sheet available on request.",
"license": "Commercial proprietary",
"deployment_model": [
"SaaS",
"cloud",
"standalone",
"integrated"
],
"os_platforms": [
"Web"
],
"features": [
"Automated denial identification and workflow",
"Denial Workflow Manager (work queues and tasking)",
"Integration of ERA and enhanced claim status",
"Analytics and reporting for denial trends",
"Root cause analysis and denial categorization",
"Customizable worklists by denial type and dollar amount",
"ANSI reason and payer proprietary code mapping",
"Appeals identification and tracking",
"Forward responses to HIS/PMS systems",
"Can operate standalone or integrate with ClaimSource"
],
"optional_modules": [
"Integration with ClaimSource®",
"Contract Manager / Contract Analysis integration",
"Enhanced Claim Status integration"
],
"integrations": [
"Experian ClaimSource",
"Experian Contract Manager",
"Experian Enhanced Claim Status",
"HIS / PMS systems (forwarding responses)",
"Payer ERA (electronic remittance) systems"
],
"data_standards": [
"ANSI reason codes",
"X12 835 (ERA)",
"Enhanced Claim Status (X12 277 / related enhanced status transactions)"
],
"api_available": "yes",
"system_requirements": "",
"compliance": [
"HIPAA"
],
"certifications": [],
"security_features": [
"Encryption (in transit and at rest)",
"Role-based access control (RBAC)",
"Audit logging",
"Single sign-on (SSO) support"
],
"privacy_features": [
"Business Associate Agreement (BAA) available",
"Data minimization and access controls"
],
"data_residency": "",
"customers": [
"Schneck Medical Center",
"Summit Medical Group Oregon",
"UT Medical Center",
"St. Luke's Health System",
"Providence Health",
"Virtua Health",
"IU Health"
],
"user_reviews": [],
"ratings": [
"KLAS - Ranked Best in KLAS in Claims Management (Experian Health) (2024)",
"Black Book - Top client-rated Denial & Claims Management Outsourcing (2024)"
],
"support_channels": [
"phone",
"client_portal",
"account_management",
"implementation_support",
"documentation",
"ticketing"
],
"training_options": [
"documentation",
"webinars",
"live_online",
"onsite",
"implementation_training"
],
"release_year": "",
"integration_partners": [
"ClaimSource",
"Claim Scrubber",
"Contract Manager",
"Enhanced Claim Status",
"OneSource",
"Collections Optimization Manager",
"Order Manager",
"Patient Estimates",
"Patient Financial Clearance",
"Payer Alerts"
],
"id": "P0580",
"slug": "experian-denial-management",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/experian-denial-management.json"
}
}