Experian Health

by Experian
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OVERVIEW

Comprehensive revenue cycle management, identity management, and patient engagement solutions powered by data and AI for healthcare organizations.

Experian Health is a leading provider of data-driven solutions for the healthcare industry, serving over 3,000 hospitals and 7,000 other healthcare organizations, representing more than 500,000 providers. Founded in 1994, the company is recognized as a Software-as-a-Service (SaaS) pioneer in the health IT space.

The platform's core offerings are segmented into Revenue Cycle Management, Identity Management, Patient Engagement, Data & Analytics, and Regulatory Solutions. A key focus is on leveraging artificial intelligence (AI) and machine learning (ML) to solve complex administrative problems, such as claim denials.

Key Capabilities and Value Proposition:

  • Revenue Cycle Optimization: Solutions like the AI-powered Patient Access Curator™ prevent claim denials in real-time at registration by verifying and correcting data across eligibility, insurance discovery, and demographics with a single automated inquiry. Other tools, such as Denials Workflow Manager and Claim Scrubber, further streamline the claims process and collections.
  • Patient Access and Engagement: The platform simplifies the patient journey with tools for online scheduling (Patient Schedule), real-time insurance eligibility verification, and Patient Estimates for price transparency, helping providers comply with regulations like the Hospital Price Transparency Rule and the No Surprises Act.
  • Data & Analytics: Power Reporting provides intuitive dashboards for continuous revenue stream analysis, and Power Data™ automates the delivery of raw data to an organization's enterprise data warehouse.
  • Identity Management: Solutions focus on unique patient identification and identity verification to protect patient data and improve record accuracy.

The system is designed for high-degree integration with existing Electronic Health Record (EHR) and Practice Management (PM) systems, reducing the administrative burden on staff and enhancing the patient financial experience.

RATING & STATS

User Rating
4.8/5.0
2524 reviews
Customers
10,000+
Founded
1994

KEY FEATURES

  • Patient Access Curator™ (AI-powered denial prevention)
  • Real-time Eligibility Verification
  • Coverage Discovery®
  • Patient Estimates/Price Transparency
  • Denials Workflow Manager
  • Power Reporting & Data Analytics
  • Identity Management & Unique Patient Identifiers
  • Patient Scheduling (Self-Service & Call Center)

PRICING

Model: enterprise
Pricing is not publicly disclosed and is provided upon request, typically structured as an enterprise-level subscription based on modules purchased and the size of the healthcare organization.

TECHNICAL DETAILS

Deployment: saas, cloud
Platforms: web, windows, mac, ios, android
📱 Mobile Apps🔌 API Available

USE CASES

Revenue Cycle Management (RCM) OptimizationPatient Access and RegistrationRegulatory Compliance (Price Transparency, No Surprises Act)Patient Identity ManagementPatient Engagement and Scheduling

INTEGRATIONS

EpicathenahealthSalesforce

COMPLIANCE & SECURITY

Compliance:
HIPAASOC2 Type IIPCI DSS Level One Service ProviderGLBAFCRA
Security Features:
  • 🔒Encryption (Data in Transit)
  • 🔒Access Controls (Business Need Required)
  • 🔒Security Audits
  • 🔒Penetration Testing

SUPPORT & IMPLEMENTATION

Support: phone, email, consultants, account management
Implementation Time: 1-3 months
Target Company Size: medium, enterprise
TRAINING AVAILABLE

PROS & CONS

✓ Pros:
  • +High degree of integration with existing EHR/PM systems
  • +AI and machine learning for real-time denial prevention (Patient Access Curator)
  • +Comprehensive suite covering RCM, identity, and patient engagement
  • +Strong support and consulting services for workflow optimization
✗ Cons:
  • -Can feel rigid in terms of customization options for certain modules
  • -Enterprise pricing is not publicly transparent and requires a direct quote

ABOUT EXPERIAN

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