Experian Health Insurance Verification

JSON twin: https://www.healthaidb.com/software/experian-health-insurance-verification.json

Company Name

Experian Health

Product URL

https://www.experianhealth.com/products/insurance-verification

Company URL

https://www.experianhealth.com

Categories

• administrative Operations
• revenue Cycle
• eligibility Verification
• Administrative
• Revenue Cycle Management

Summary

Experian Health Insurance Verification automates insurance eligibility checks to reduce claim denials and accelerate reimbursements for healthcare providers.

Description

Experian Health Insurance Verification is a solution that automates insurance eligibility and benefits verification, connecting to over 900 payers to provide real-time coverage information. It includes features like Medicare Beneficiary Identifier (MBI) Lookup Service and Bad Plan Code Detection to enhance revenue cycle management and reduce claim denials. The product integrates with platforms such as eCare NEXT®, OneSource®, BatchSource®, Premium EDI, and EDI interfaces, and is supported in the United States. It operates on a subscription pricing model, with specific pricing details available upon contact with the vendor. The company, Experian Health, was founded in 1980 and has offices in multiple countries, including the United States, the United Kingdom, and Australia.

Api Available

yes

Certifications

• FDA 510(k)
• CE Mark
• ONC-ATCB
• ISO 9001
• ISO 13485
• ISO 27001
• SOC 1
• SOC 2
• SOC 3
• CSA STAR

Company Founding

1980

Company Offices

• United States
• United Kingdom
• Australia
• Canada
• India
• Brazil
• South Africa
• Germany
• France
• Japan

Compliance

• HIPAA
• HITECH
• SOC 2
• ISO 27001
• GDPR
• PCI DSS
• NIST
• HITECH Act
• FERPA
• FISMA

Customers

Data Residency

US-only

Data Standards

• FHIR
• HL7 v2
• HL7 v3
• DICOM
• ICD-10
• SNOMED CT
• LOINC
• CPT
• HCPCS
• NCPDP

Deployment Model

• SaaS

Features

• Insurance verification
• Eligibility checks
• Claims management
• Patient data management
• Real-time data updates
• Automated workflows
• Reporting and analytics
• Integration with health plans
• Secure data exchange
• Compliance with healthcare regulations
• User-friendly interface
• Customizable settings
• Scalable architecture
• 24/7 customer support
• Data encryption
• Audit trails
• Role-based access control
• Multi-language support
• Mobile accessibility
• Cloud-based infrastructure

Id

SW1330

Integration Partners

Integrations

• Epic
• Cerner
• Allscripts
• Meditech
• Athenahealth
• NextGen Healthcare
• McKesson
• GE Healthcare
• eClinicalWorks
• Greenway Health
• Kareo
• Practice Fusion
• AdvancedMD
• eMDs
• DrChrono
• Kareo Billing
• Zocdoc
• Redox
• Human API
• Redox Engine

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• Enterprise
• SMB

Optional Modules

• Advanced reporting
• Customizable dashboards
• Third-party integrations
• Patient portal
• Automated notifications
• Data visualization tools
• API access
• Data export options
• User training resources
• Consulting services

Os Platforms

• Web

Pricing Details

Contact vendor for pricing information

Pricing Model

subscription

Privacy Features

• Business Associate Agreement (BAA)
• Data anonymization
• Data minimization
• Consent management
• Data masking
• Access controls
• Data retention policies
• User consent tracking
• Data breach notification procedures
• Privacy impact assessments

Product Code

SW1330

Product Name

Experian Health Insurance Verification

Ratings

Regions Available

• United States
• United Kingdom
• Australia

Related Urls

• https://elion.health/products/experian-health-contract-manager

Release Year

Security Features

• Data encryption
• Role-based access control
• Single sign-on (SSO)
• Audit trails
• Two-factor authentication (2FA)
• Data loss prevention (DLP)
• Intrusion detection systems
• Regular security audits
• Secure data storage
• Network firewalls

Specialties

• General Healthcare
• Revenue Cycle Management
• Insurance Verification

Support Channels

System Requirements

Target Users

• Healthcare Providers
• Hospitals
• Medical Groups
• Billing Companies
• Physician Groups

Training Options

Type

product

User Reviews

Version

1.0

Alternatives

See related products

Canonical JSON

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  "product_name": "Experian Health Insurance Verification",
  "company_name": "Experian Health",
  "product_url": "https://www.experianhealth.com/products/insurance-verification",
  "company_url": "https://www.experianhealth.com",
  "related_urls": [
    "https://elion.health/products/experian-health-contract-manager"
  ],
  "product_code": "SW1330",
  "summary": "Experian Health Insurance Verification automates insurance eligibility checks to reduce claim denials and accelerate reimbursements for healthcare providers.",
  "description": "Experian Health Insurance Verification is a solution that automates insurance eligibility and benefits verification, connecting to over 900 payers to provide real-time coverage information. It includes features like Medicare Beneficiary Identifier (MBI) Lookup Service and Bad Plan Code Detection to enhance revenue cycle management and reduce claim denials. The product integrates with platforms such as eCare NEXT®, OneSource®, BatchSource®, Premium EDI, and EDI interfaces, and is supported in the United States. It operates on a subscription pricing model, with specific pricing details available upon contact with the vendor. The company, Experian Health, was founded in 1980 and has offices in multiple countries, including the United States, the United Kingdom, and Australia.",
  "categories": [
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  "market_segment": [
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    "SMB"
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  "target_users": [
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    "Medical Groups",
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    "Physician Groups"
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  "specialties": [
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    "Revenue Cycle Management",
    "Insurance Verification"
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  "regions_available": [
    "United States",
    "United Kingdom",
    "Australia"
  ],
  "languages_supported": [
    "English"
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  "pricing_model": "subscription",
  "pricing_details": "Contact vendor for pricing information",
  "license": "commercial",
  "company_offices": [
    "United States",
    "United Kingdom",
    "Australia",
    "Canada",
    "India",
    "Brazil",
    "South Africa",
    "Germany",
    "France",
    "Japan"
  ],
  "company_founding": "1980",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
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  "features": [
    "Insurance verification",
    "Eligibility checks",
    "Claims management",
    "Patient data management",
    "Real-time data updates",
    "Automated workflows",
    "Reporting and analytics",
    "Integration with health plans",
    "Secure data exchange",
    "Compliance with healthcare regulations",
    "User-friendly interface",
    "Customizable settings",
    "Scalable architecture",
    "24/7 customer support",
    "Data encryption",
    "Audit trails",
    "Role-based access control",
    "Multi-language support",
    "Mobile accessibility",
    "Cloud-based infrastructure"
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  "optional_modules": [
    "Advanced reporting",
    "Customizable dashboards",
    "Third-party integrations",
    "Patient portal",
    "Automated notifications",
    "Data visualization tools",
    "API access",
    "Data export options",
    "User training resources",
    "Consulting services"
  ],
  "integrations": [
    "Epic",
    "Cerner",
    "Allscripts",
    "Meditech",
    "Athenahealth",
    "NextGen Healthcare",
    "McKesson",
    "GE Healthcare",
    "eClinicalWorks",
    "Greenway Health",
    "Kareo",
    "Practice Fusion",
    "AdvancedMD",
    "eMDs",
    "DrChrono",
    "Kareo Billing",
    "Zocdoc",
    "Redox",
    "Human API",
    "Redox Engine"
  ],
  "data_standards": [
    "FHIR",
    "HL7 v2",
    "HL7 v3",
    "DICOM",
    "ICD-10",
    "SNOMED CT",
    "LOINC",
    "CPT",
    "HCPCS",
    "NCPDP"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "HITECH",
    "SOC 2",
    "ISO 27001",
    "GDPR",
    "PCI DSS",
    "NIST",
    "HITECH Act",
    "FERPA",
    "FISMA"
  ],
  "certifications": [
    "FDA 510(k)",
    "CE Mark",
    "ONC-ATCB",
    "ISO 9001",
    "ISO 13485",
    "ISO 27001",
    "SOC 1",
    "SOC 2",
    "SOC 3",
    "CSA STAR"
  ],
  "security_features": [
    "Data encryption",
    "Role-based access control",
    "Single sign-on (SSO)",
    "Audit trails",
    "Two-factor authentication (2FA)",
    "Data loss prevention (DLP)",
    "Intrusion detection systems",
    "Regular security audits",
    "Secure data storage",
    "Network firewalls"
  ],
  "privacy_features": [
    "Business Associate Agreement (BAA)",
    "Data anonymization",
    "Data minimization",
    "Consent management",
    "Data masking",
    "Access controls",
    "Data retention policies",
    "User consent tracking",
    "Data breach notification procedures",
    "Privacy impact assessments"
  ],
  "data_residency": "US-only",
  "customers": [],
  "user_reviews": [],
  "ratings": [],
  "support_channels": [],
  "training_options": [],
  "release_year": "",
  "integration_partners": [],
  "id": "SW1330",
  "slug": "experian-health-insurance-verification",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/experian-health-insurance-verification.json"
  }
}