Added capabilities help healthcare organizations automate income and employment verification, help identify Medicaid and financial assistance eligibility faster, and reduce administrative burden amid regulatory eligibility requirements
Key Highlights:
- As new Medicaid eligibility verification requirements take effect on January 1, 2027, Experian Health can help healthcare providers quickly verify income and employment information to support coverage and financial assistance screening.
- Patient Financial Clearance now provides instant income and employment information in seconds, reducing manual verification efforts and streamlining patient access workflows.
- With this capability, healthcare organizations can more easily assess their patient population at scale, mitigate coverage risk and accelerate reimbursement.
As healthcare organizations prepare for new Medicaid eligibility verification requirements under the One Big Beautiful Bill Act (OBBBA), Experian Health today announced the addition of income and employment verification capabilities to Patient Financial Clearance, its financial pathway product that helps screen patients for financial assistance and reduce bad debt. The solution gives healthcare providers instant access to verified income and employment information, helping organizations automate Medicaid screening processes, support eligibility determinations, and reduce reliance on manual verification efforts.
Turning Regulatory Change into Operational Readiness
New Medicaid eligibility requirements give individuals 30 days to submit documentation if their employment or exemption status cannot be verified before coverage can be denied or terminated. As a result, timely and accurate verification is becoming increasingly critical. Without current information to help determine Medicaid compliance, healthcare providers risk denied Medicaid claims and patients may face unexpected bills, leading to reimbursement delays, patient confusion, and added friction throughout the care journey.
Patient Financial Clearance already helps providers assess propensity to pay, identify patients who may qualify for Medicaid or financial assistance programs, and recommend the most appropriate financial pathway before or at the point of service. Through an integration with Experian Verify, Experian Health now seamlessly offers income and employment verification enhancing providers' ability to validate eligibility information in real time.
"Healthcare organizations are facing a rapidly changing eligibility environment that requires more frequent and reliable verification of patient financial information," said Nora Iluri, Chief Product Officer at Experian Health. "One of the greatest strengths of Experian is our ability to bring together data, technology and expertise from across the enterprise to quickly address emerging market needs. By integrating Experian Verify into Patient Financial Clearance, we're helping providers navigate new verification requirements, reduce administrative burden and connect patients to the coverage and financial assistance they need. This is a powerful example of how we're delivering on our mission to simplify healthcare for all."
Adding to the complexity among providers is Medicaid Redetermination, an annual eligibility renewal process for patients. This practice and upcoming regulatory changes are expected to increase the volume and sophistication of eligibility and financial assistance screening activities, creating new administrative demands for patient access and revenue cycle teams. Experian Health research shows that nearly 40% of providers report that Medicare and Medicaid policy or eligibility changes make reimbursement processes more challenging1
The new integrated solution will help providers:
- Automate income and employment verification within financial clearance workflows
- Support Medicaid and financial assistance eligibility screening with verified data
- Reduce manual document collection and verification efforts
- Accelerate financial conversations and patient access processes
- Deliver a more streamlined and transparent patient financial experience
Bringing Verification Directly into Provider Workflows
Experian Verify provides access to one of the nation's largest instant employer payroll networks with millions of unique payroll records, enabling providers to verify income and employment information in seconds through automated workflows. When payroll data is unavailable, the solution can leverage consumer-permissioned payroll access and document upload capabilities, creating a comprehensive, multi-layered verification approach. Current Patient Financial Clearance clients can add this capability, while other Experian Health clients can access it as a stand-alone solution.
"Whether they're applying for a home, starting a new job or accessing essential services, Experian plays an important role in helping people move forward during some of life's most meaningful moments," said Ryan Rosales, senior vice president and general manager for Experian Verification Solutions. "By integrating Experian Verify into the healthcare experience, we're extending the value of instant income and employment verification to another critical moment in a consumer's life and helping to reduce friction at a time when patients should be focused on getting the care they need."
As healthcare providers contend with increasing verification requirements, the combination of Patient Financial Clearance and Experian Verify helps enable organizations to balance compliance, operational efficiency and patient support. Patients can also complete portions of the financial assistance process digitally, including application submission, document upload and status tracking, helping reduce friction for both patients and staff.
For more information about Experian Health and Patient Financial Clearance, visit https://www.experian.com/healthcare/products/payment-tools/patient-collections-and-financial-clearance.
About Experian Health
At Experian Health, we serve more than 60 percent of U.S. hospitals and more than 5,800 medical practices, labs, pharmacies and other healthcare providers to simplify healthcare with data-driven platforms and insights that help our clients make smarter business decisions, deliver a better bottom line and establish strong patient relationships.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. We invest in talented people and new advanced technologies to unlock the power of data and to innovate. A FTSE 100 Index company listed on the London Stock Exchange (EXPN), we have a team of 25,200 people across 33 countries. Our corporate headquarters are in Dublin, Ireland. Learn more at experianplc.com.
For more information about Experian Health, visit http://www.experian.com/healthcare/. Learn more about Experian at www.experianplc.com.
- Experian State of Claims Survey, 2026
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Contacts:
Sandra Bernardo
Experian
1 949 529 7550
sandra.bernardo@experian.com
