JSON twin: https://www.healthaidb.com/software/experian-insurance-verification.json
Experian Health
https://www.experian.com/healthcare/
Experian Insurance Verification is an automated eligibility and benefits verification solution that performs real-time insurance checks, MBI lookup, and payer normalization to reduce denials and speed reimbursement.
A commercial healthcare patient-access product from Experian Health that connects to a large payer network (900+ payers) to deliver real-time eligibility, benefits, and Medicare Beneficiary Identifier (MBI) lookups; provides data normalization, bad-plan-code detection, automated work queues, and integrations via eCare NEXT, OneSource, batch/EDI interfaces to streamline registration and revenue-cycle workflows.
yes
1996
US-based hosting (contact vendor for other region options)
P0584
2025-09-07
proprietary commercial
Contact vendor for pricing, enterprise contracts and implementation options; no public list prices; demos/trials via sales.
enterprise_quote
SaaS/cloud; supports real-time APIs, EDI/batch interfaces
product
1.0
{
"company_name": "Experian Health",
"company_url": "https://www.experian.com/healthcare/",
"company_offices": [
"United States",
"United Kingdom",
"Ireland",
"Canada",
"Australia"
],
"company_founding": "1996",
"product_url": "https://www.experian.com/healthcare/products/patient-access-registration/insurance-eligibility-verification",
"categories": [
"administrative",
"revenue cycle management",
"patient access",
"identity matching",
"insurance eligibility verification"
],
"market_segment": [
"enterprise",
"smb"
],
"links": [
"https://www.experian.com/healthcare/products/patient-access-registration/insurance-eligibility-verification",
"https://www.experian.com/healthcare/",
"https://www.experian.com/healthcare/about",
"https://www.experian.com/healthcare/products/patient-access-registration/check-patient-health-insurance-lookup",
"https://elion.health/products/experian-insurance-verification",
"https://www.g2.com/sellers/experian",
"https://klasresearch.com/vendor-ratings/experian-health/63709",
"https://www.trustradius.com/products/experian-health/reviews",
"https://www.experian.com/healthcare/client-services/experian-locations-contact"
],
"summary": "Experian Insurance Verification is an automated eligibility and benefits verification solution that performs real-time insurance checks, MBI lookup, and payer normalization to reduce denials and speed reimbursement.",
"description": "A commercial healthcare patient-access product from Experian Health that connects to a large payer network (900+ payers) to deliver real-time eligibility, benefits, and Medicare Beneficiary Identifier (MBI) lookups; provides data normalization, bad-plan-code detection, automated work queues, and integrations via eCare NEXT, OneSource, batch/EDI interfaces to streamline registration and revenue-cycle workflows.",
"target_users": [
"revenue cycle managers",
"patient registration staff",
"billing/coding teams",
"financial clearance teams",
"health system administrators",
"payor relations teams"
],
"specialties": [
"hospital/health system",
"ambulatory care",
"medical groups",
"pharmacy",
"diagnostics"
],
"regions_available": [
"United States",
"United Kingdom",
"Canada",
"Australia"
],
"languages_supported": [
"English"
],
"pricing_model": "enterprise_quote",
"pricing_details": "Contact vendor for pricing, enterprise contracts and implementation options; no public list prices; demos/trials via sales.",
"license": "proprietary commercial",
"deployment_model": [
"SaaS",
"cloud"
],
"os_platforms": [
"Web"
],
"features": [
"Real-time insurance eligibility verification",
"Batch eligibility processing",
"MBI (Medicare Beneficiary Identifier) lookup service",
"Bad Plan Code (BPC) detection",
"Eligibility normalization across payers",
"Data enrichment from payer sources",
"Work queues with preset/custom alerts",
"Coverage discovery (find previously unidentified coverage)",
"Search/identity matching for patient records",
"Integration options: eCare NEXT, OneSource, BatchSource, Premium EDI/EDI"
],
"optional_modules": [
"MBI Lookup Tool",
"Coverage Discovery",
"Patient Intake / Patient Estimates (complementary modules)"
],
"integrations": [
"Epic (customer testimonial mentions integration)",
"eCare NEXT",
"OneSource",
"BatchSource",
"Premium EDI / EDI interfaces",
"900+ payer connections (clearinghouse connectivity)",
"CAQH Coordination of Benefits data"
],
"data_standards": [
"X12 EDI",
"CAQH COB (Coordination of Benefits data)"
],
"api_available": "yes",
"system_requirements": "SaaS/cloud; supports real-time APIs, EDI/batch interfaces",
"compliance": [
"HIPAA"
],
"certifications": [],
"security_features": [
"Encryption (in transit and at rest)",
"Audit logging",
"Role-based access controls (RBAC)",
"SSO (enterprise sign-on integration)"
],
"privacy_features": [
"BAA available",
"Data minimization / normalization"
],
"data_residency": "US-based hosting (contact vendor for other region options)",
"customers": [
"Providence Health"
],
"user_reviews": [],
"ratings": [],
"support_channels": [
"phone",
"account management",
"implementation support",
"documentation",
"online form/contact request"
],
"training_options": [
"documentation",
"webinars",
"live_online (remote implementation/training)",
"onsite (implementation/consulting)",
"implementation services"
],
"release_year": "",
"integration_partners": [
"Epic",
"eCare NEXT",
"OneSource",
"BatchSource",
"Premium EDI",
"EDI interfaces",
"CAQH (Coordination of Benefits data)",
"MBI Lookup Service"
],
"id": "P0584",
"slug": "experian-insurance-verification",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/experian-insurance-verification.json"
}
}