Sohar Health enables eligibility verification and AI-powered medical coding for behavioral health providers. Sohar offers integration with EHR systems and APIs, enhancing workflow efficiency and enabling easy integration into existing systems.

pVerify specializes in verifying patient insurance eligibility and benefits across a wide range of payers, including Medicare, Medicaid, and commercial providers. It supports diverse healthcare sectors through advanced eligibility checks, batch verification, and integration with electronic health records and practice management software.

Waystar is an end-to-end revenue cycle management company, offering eligibility verification, claims submission, payment posting, denials management, and analytics.

Opkit is a customizable AI outbound phone call platform with both AI agents and human agents. Common use-cases include eligibility checks, prior authorizations, denied claim appeals, formulary checks, and appointment scheduling.

Silna Health focuses on helping specialty healthcare providers manage prior authorizations, benefits, and eligibility checks. It is designed for use in physical therapy, speech therapy, and behavioral health. Silna automates the authorization process using AI, provides regular benefit and eligibility checks, and sends reminders for expiring authorizations to prevent lapses in care.

SuperDial is a platform for AI-enabled payer phone calls for insurance verification, prior authorization, credentialing and enrollment, and claim follow-ups. It offers a low-code UI for configuring call flows, placing calls, and viewing call results.

Availity Essentials is an end-to-end RCM solution for providers. It offers a range of features aimed at improving efficiency and accuracy in tasks such as eligibility and benefits verification, claims management, and prior authorization.

Clearwave is a comprehensive healthcare platform designed to optimize patient engagement and administrative efficiency in hospitals and health systems. Its core capabilities include the automation of critical processes such as patient scheduling, registration, and eligibility verification for insurance. Additionally, Clearwave's system supports real-time eligibility verification with payers, facilitates a contactless check-in experience, and offers a digital front door for scheduling.

Develop Health is an AI-enabled eligibility checking and prior authorization platform for medication. It automates benefit verification, clinical eligibility checks, and prior authorization form completion, and automatically calls payers to get benefit details. By integrating patient insurance data and clinical history, the platform increases first-time approval rates and reduces delays in accessing medications.

Eligible provides APIs for streamlining insurance billing, including eligibility checks, insurance verifications, real-time cost estimations, and filing of insurance claims. Eligible offers a REST API that uses JSON, as well as Ruby, C#, Java, and Node.js SDKs.

Experian Insurance Verification automates eligibility and coverage checks for providers. Beyond coverage checks, it supports Medicare reimbursements by offering an automated MBI Lookup Service that identifies missing or invalid MBIs along with Medicare benefit coverage.

FinThrive Patient Access is designed to enhance the patient financial experience by improving price transparency, streamlining digital check-ins, and increasing efficiency in revenue collection. It enables patient scheduling and intake, eligibility checking, payment collection, and price estimates.

Health Harbor is an AI agent that calls insurance companies for eligibility and claim status checks.

MaxRTE provides insurance verification software to assist with real-time eligibility and insurance discovery.

Nirvana Health offers real-time mental health insurance verification and cost estimates via both API and web UI. Features include cardless eligibility checking and automated benefits reverification.

Pledge Health offers an automated patient billing and payments platform, focusing on insurance benefit verifications, patient cost estimates, patient statements, and payment processes to enhance the financial experience for both healthcare providers and their patients

Rivet Patient Pricing generates accurate patient cost estimates in compliance with the No Surprises Act, allowing patients to see their deductible and out-of-pocket costs. The system integrates with EHR and practice management systems, automating eligibility checks, and aligning contracted rates with insurance benefits. It provides customizable payment terms, batch communication, and upfront payment collection.

TruBridge Patient Access streamlines patient registration processes, automates real-time insurance eligibility checks, and provides patient estimation, which allows providers to offer precise cost estimates to patients before services are rendered. This includes considering factors such as insurance coverage, co-pays, and deductibles, helping patients understand their financial obligations upfront. Additionally, TruBridge facilitates upfront collections for patients.

Veritable is a healthcare IT solution focused on insurance eligibility verification and claim status checks. It allows medical practices to access information from over 1,500 insurance payers, reducing administrative burdens and improving operational efficiency. The platform helps avoid claim denials and delays by confirming coverage before services are provided.

Wendi is an AI-powered digital assistant for patient engagement from initial contact through scheduling and eligibility checking.