Patient Price Estimation
Patient Price Estimation tools enables providers to generate accurate and transparent cost estimates for patients prior to receiving medical services. This category focuses on tools and products designed to help providers create Good Faith Estimates (GFEs) in compliance with regulatory requirements. Accurate GFEs help patients understand their potential financial obligations, reduce surprise billing, and support informed consent. These products enable key workflows including:
Data Collection: Gathering relevant patient information, including insurance details, medical history, and the specific services or procedures anticipated.
Cost Calculation: Using advanced algorithms and up-to-date pricing information to calculate the estimated cost of services. This includes all potential charges such as procedures, tests, consultations, and any associated fees.
Transparency: Presenting the estimated costs in a clear and understandable format for patients. This helps patients make informed decisions about their healthcare and financial planning.
Compliance: Ensuring that the estimates meet regulatory standards, particularly the requirements set by laws such as the No Surprises Act. This involves providing detailed and accurate GFEs to patients.
Communication: Effectively communicating the cost estimates to patients, including explaining any potential variables that might affect the final bill.
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Careviso
Careviso SeeQer
Company Info
Founded: 2017
Headcount: 51-200
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
CareViso's seeQer platform provides tools for verifying patient insurance coverage, confirming benefits, and estimating out-of-pocket costs before treatment. It helps providers maintain price transparency compliance by informing patients about their financial responsibilities, including deductible, copay, and coverage details, before care begins. SeeQer integrates real-time data from multiple sources to streamline pre-treatment benefits investigations, coverage confirmations, and cost estimations.
Change Healthcare
Change Clearance Estimator
Company Info
Founded: 2007
Headcount: 5001-10000
Customers
Verified Customers: 3
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Change Healthcare's Clearance Estimator enables healthcare providers to calculate and share detailed cost estimates with patients before treatment. It uses data from payer contracts, patient benefits, and historical charge information to model expected costs for services like physician fees, outpatient care, and inpatient care. The tool helps providers comply with the No Surprises Act by delivering Good Faith Estimates, aiming to reduce surprise billing and enhance patient satisfaction through financial transparency.
ClaraPrice
ClaraPrice Good Faith Estimates
Company Info
Founded: 2019
Headcount: 1-10
Customers
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
ClaraPrice Good Faith Estimates tool helps healthcare providers comply with the No Surprises Act by offering a platform to create, manage, and deliver accurate cost estimates for patients. It features workflow automation, collaborative tools, and pre-configured templates to streamline the estimation process across multiple locations. The platform ensures estimates are accessible and can be integrated into existing EHR systems.
MDClarity
Clarity Flow
Company Info
Founded: 2010
Headcount: 11-50
Customers
Verified Customers: 4
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
MDClarity's Clarity Flow automates patient billing and collections, offering transparency and efficiency in the healthcare revenue cycle. The platform provides tools for upfront price estimates, eligibility checks, and real-time payment tracking. It integrates with EHR and practice management systems to provide clear, accurate cost information.
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Cleargage
Cleargage Treatment Estimation
Company Info
Founded: 2009
Headcount: 51-200
Customers
Verified Customers: 1
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
ClearGage's Treatment Estimation tool allows healthcare providers to generate accurate, real-time estimates of patient out-of-pocket expenses. It incorporates contracted, self-pay, and discounted rates while checking real-time eligibility for accuracy. Estimates can be delivered to patients via text or email and reviewed through a branded patient portal.
Experian
Experian Patient Estimates
Company Info
Founded: 1980
Headcount: 5001-10000
Customers
Verified Customers: 3
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Experian Health Patient Estimates is a web-based tool designed for hospitals and medical facilities to provide accurate, upfront cost estimates to patients. It combines data from the provider’s chargemaster, claims history, payer contracts, and the patient’s insurance benefits. The tool also integrates financial assistance options like discounts and payment plans. Additionally, it supports multiple languages, custom scripts for staff, and seamless integration with hospital information systems.
FinThrive
Finthrive Patient Access
Company Info
Founded: 2016
Headcount: 1001-5000
Customers
Verified Customers: 2
Customers Served: Hospital / Health System
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
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.
HealthMe
HealthMe GFE
Company Info
Founded: 2016
Headcount: 1-10
Customers
Verified Customers: 2
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
HealthMe's GFE Engine is a tool designed to help healthcare practices comply with the Good Faith Estimate (GFE) requirements under the No Surprises Act. It allows providers to quickly generate and share cost estimates for uninsured and self-pay patients across multiple locations. The platform enables both patients and staff to create estimates, and includes secure, encrypted storage and HIPAA compliance for managing sensitive patient information.
Company Info
Founded: 1986
Headcount: 51-200
Customers
Verified Customers: 1
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
PMMC's Patient Estimates tool allows providers to generate accurate cost estimates based on contract data. The web-based tool integrates with contract management systems to deliver real-time estimates of patient financial responsibility, enabling front-end staff to provide these details quickly and collect payments at the time of service, supporting compliance with requirements like the No Surprises Act.
PVerify
PVerify Patient Estimator
Company Info
Founded: 2006
Headcount: 11-50
Customers
Verified Customers: 6
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
pVerify's Patient Estimator tool allows healthcare providers to generate real-time estimates of patient financial responsibility by using verified insurance benefits and custom fee schedules. The estimator calculates costs such as copays, coinsurance, and deductibles based on eligibility results and Medicare pricing or unique fee schedules. It also includes features like printable estimates, multi-state support, and an estimator widget for patient-facing cost estimation on websites.
Rivet
Rivet Patient Pricing
Company Info
Founded: 2018
Headcount: 51-200
Customers
Verified Customers: 5
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
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
TruBridge Patient Access
Company Info
Founded: 1979
Headcount: 1001-5000
Customers
Verified Customers: 2
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
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.
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Turquoise Health
Turquoise Health Instant GFE
Company Info
Founded: 2020
Headcount: 51-200
Customers
Verified Customers: 4
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Turquoise Health's Instant GFE (Good Faith Estimate) tool helps providers generate accurate cost estimates for patients in compliance with the No Surprises Act. It allows for instant creation, calculation, and sharing of estimates, incorporating facility and physician fees. The platform supports collaboration and batch communication.
Waystar
Waystar Price Transparency
Company Info
Founded: 2017
Headcount: 1001-5000
Customers
Verified Customers: 5
Customers Served: Digital Health Provider, Ambulatory Practice, Hospital / Health System
Product Overview
Security and Compliance Certifications: HIPAA
Waystar's Price Transparency solution enables healthcare providers to generate real-time, accurate estimates of patient costs. This tool helps patients understand their financial responsibilities by consolidating chargemaster data, contract rates, and insurance benefits. It is designed to meet CMS price transparency requirements, reduce the risk of unexpected bills, and improve patient satisfaction by providing easy access to cost estimates via online platforms.