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Health Insurance Eligibility

Verify patients’ insurance eligibility and benefits to confirm payable coverage, determine patient payments and reduce denials.

Count on accurate health insurance verification for a more streamlined billing process

The vast majority of denials — up to 90% — are preventable. Capturing accurate patient eligibility and benefits information prior to or at the time of service can help reduce denials and protect earned revenue. It can also help engage patients in the financial aspects of their care, improving the likelihood of payment.

TransUnion Healthcare’s Insurance Eligibility solution confirms payer coverage and benefits information (including copays, coinsurance and deductibles) electronically, in real time or batch throughout the billing process — from scheduling, pre-registration, registration to discharge.

Insurance Eligibility can:

Increase insurance eligibility hit rates

Reduce claims denials

Lower uncompensated care and bad debt

Improve workflow efficiency

Eliminate manual processes and expensive re-works

Lower billing and collections costs

Empower patients to better understand their insurance benefits and payment responsibility


"We like partnering with TransUnion Healthcare because they have a strong footprint in the eligibility space and have continually demonstrated a willingness to be a partner, not just a vendor. We have monthly meetings to review key areas of performance and improvement together."

Director of a Revenue Cycle Management Company

Quick Facts


ClearIQ Insurance

Insurance Eligibility

1 HFMA staff and volunteers determined that this product met specific criteria developed under the HFMA Peer Review process. HFMA does not endorse or guaranty the use of these products.

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