Healthcare doesn't have to leave billions in recoverable revenue on the table.
CareEligible Health helps hospitals identify missed eligibility and convert uncompensated care into reimbursable revenue—without adding workflow burden.
Billions in Revenue Are Lost Before Claims Are Even Filed
Annual uncompensated care written off by U.S. hospitals—much tied to patients actually eligible for reimbursement.
Hospitals write off tens of billions annually in uncompensated care, much of it tied to patients who are actually eligible for reimbursement—but never identified in time.
Eligibility is complex and fragmented
Medicaid, Medicare, disability, and state programs each operate on different rules, timelines, and documentation requirements. No single workflow captures them all.
Existing systems focus on billing, not eligibility
Revenue cycle tools are built to process claims—not to surface coverage opportunities before a claim is ever filed. The gap is structural, not operational.
Revenue is lost upstream, not just at claims
By the time a claim is denied, the opportunity is often gone. Eligibility must be identified at the point of service—or earlier—to convert it into revenue.
Introducing Eligibility Intelligence
CareEligible Health analyzes clinical and administrative data to identify eligibility opportunities in real time and convert them into reimbursable revenue.
Eligibility Detection at Scale
Analyzes clinical and administrative data in real time to surface patients who qualify for Medicaid, Medicare, disability, and state programs—before claims are filed.
Clinical Data Modeling
Integrates with existing EHR and RCM systems to build a complete eligibility profile for each patient encounter, drawing on diagnosis codes, demographics, and payer history.
Zero-Disruption Workflow Integration
Surfaces eligibility opportunities directly within existing staff workflows. No new systems to learn. No additional headcount required. Results appear where your team already works.
Automated Documentation Support
Generates the documentation required to support eligibility applications and appeals, reducing administrative burden and accelerating time-to-reimbursement.
A Better Outcome for Every Stakeholder
Eligibility intelligence creates compounding value across the care ecosystem—for the institutions that deliver care, the patients who receive it, and the communities that depend on it.
For Hospitals
Identify patients who qualify for coverage programs and convert write-offs into reimbursable claims before they age out.
Systematic eligibility recovery strengthens the revenue base without requiring capital investment or new headcount.
The platform integrates into existing workflows and surfaces opportunities automatically—your team acts on results, not on research.
For Patients
Patients who qualify for coverage programs are identified and enrolled before bills become burdens, reducing downstream financial hardship.
Many patients are unaware they meet eligibility criteria for Medicaid, Medicare, or disability benefits. CareEligible closes that gap.
Patients with active coverage are more likely to follow through on care plans, reducing readmissions and improving outcomes.
For Communities
When hospitals recover revenue from eligible patients, they can sustain and expand services in underserved communities.
Connecting eligible individuals to coverage programs reduces the systemic cost of uncompensated care across the health system.
Communities with higher coverage rates demonstrate better population health metrics, lower emergency utilization, and improved chronic disease management.
Built on Zero Trust Principles
Healthcare data demands the highest level of security. CareEligible Health is architected from the ground up using Zero Trust security principles—never assuming trust, always verifying, and continuously monitoring every access point.
Never Trust, Always Verify
Every access request—whether from users, devices, or systems—is authenticated and authorized in real-time, regardless of network location or previous trust status.
Encrypt Everything
Patient data is encrypted in transit (TLS 1.3) and at rest using AES-256. Encryption keys are managed independently and rotated regularly.
Least Privilege Access
Users and services are granted only the minimum permissions required to perform their specific function. Access is continuously monitored and revoked when no longer needed.
Continuous Monitoring
All data access, API calls, and system changes are logged and analyzed in real-time. Anomalies trigger immediate alerts and automated response protocols.
Compliance & Standards
Unlock Revenue You're Already Entitled To
Join health systems exploring how eligibility intelligence can transform revenue recovery. Let's discuss your specific challenges and opportunities.