Experian Health has acquired eInsights, a company that finds patient insurance coverage that providers missed at registration.
eInsights searches for coverage after care is delivered, including retroactive Medicaid, secondary coverage and coordination of benefits, according to an Oct. 20 news release. The company also offers timely filing denial prevention and Disproportionate Share Hospital reporting. It has helped its more than 200 U.S. healthcare clients recover more than $225 million in reimbursement. Experian Health’s current insurance discovery tools work at the front end of the revenue cycle. The acquisition extends that work to the back end.
The deal comes as health systems prepare for more frequent Medicaid eligibility checks starting Jan. 1, 2027. when provisions of HR 1 take effect. The law requires states to redetermine eligibility for adults covered through Medicaid expansion every six months instead of annually. When coverage changes, or only surfaces after a visit, providers can lose reimbursement they are owed. Patients can also be billed for care their insurance should have covered.
“Finding insurance coverage shouldn’t be a one-time event,” Experian Health President Jason Considine said in the release.
Mr. Considine said cost, regulatory and operational pressures leave providers little room to lose revenue. He said eInsights gives clients another chance to find coverage, from the start of a patient’s journey through the back end of the revenue cycle.
Experian Health serves more than 60% of U.S. hospitals and more than 5,800 medical practices, labs, pharmacies and other providers, according to the release.
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