Top 10 Best Eligibility Verification Software of 2026

Availity is a leading healthcare revenue cycle management platform specializing in real-time eligibility and benefit verification for providers across the US. It connects to over 2,000 payers, representing more than 1 billion covered lives, enabling instant checks on patient coverage, deductibles, copays, and authorizations. Beyond eligibility, it supports claims management, remittance advice, and payer-provider collaboration through a secure web portal and API integrations.

Waystar is a leading revenue cycle management platform with robust eligibility verification capabilities, allowing healthcare providers to perform real-time and batch checks on patient insurance coverage across thousands of payers. It automates benefit verification, copay estimates, and prior authorization status to minimize denials and accelerate reimbursements. Integrated with major EHR systems, Waystar provides actionable insights and analytics to optimize front-end revenue cycle processes.

Experian Health's Eligibility Verification Software delivers real-time patient insurance eligibility checks, confirming coverage, deductibles, copays, and authorizations across thousands of payers. Integrated with EHR/EMR systems, it automates verification processes to minimize claim denials and accelerate revenue cycle management. Leveraging Experian's vast data network, it provides accurate, comprehensive benefits data to support efficient patient access workflows.

Optum, a division of UnitedHealth Group, offers robust eligibility verification solutions as part of its comprehensive revenue cycle management platform. The software enables healthcare providers to perform real-time insurance eligibility checks, verify benefits, and obtain authorizations across a vast network of payers. It integrates seamlessly with EHRs and practice management systems to streamline workflows and minimize claim denials.

athenahealth, through its athenaOne platform, offers robust eligibility verification as part of its integrated EHR and revenue cycle management suite. It provides real-time insurance eligibility checks across over 1,000 payers, confirming coverage, deductibles, copays, and authorizations to streamline front-office workflows. This automation reduces claim denials and accelerates reimbursement for healthcare practices.

Kareo is a cloud-based practice management and EHR platform that includes robust eligibility verification tools for healthcare providers. It enables real-time checks of patient insurance eligibility, benefits, copays, deductibles, and prior authorizations with over 4,000 payers directly from the patient dashboard. The software integrates these verifications seamlessly into billing, scheduling, and revenue cycle workflows to reduce denials and streamline operations.

AdvancedMD is a comprehensive cloud-based practice management and EHR platform that includes robust eligibility verification capabilities for healthcare providers. It enables real-time and batch insurance eligibility checks across hundreds of payers, delivering instant details on coverage status, copays, deductibles, and authorizations. Integrated seamlessly with billing and scheduling modules, it minimizes claim denials and supports efficient revenue cycle management.

Office Ally is a web-based medical billing platform that offers free eligibility verification services for healthcare providers. It supports real-time and batch checks for patient insurance coverage across thousands of payers, helping practices confirm benefits before appointments. Beyond eligibility, it includes claims submission, ERA posting, and basic practice management tools, all accessible without software installation.

NextGen Healthcare provides robust eligibility verification as part of its integrated EHR and practice management platform, enabling real-time checks of patient insurance coverage, deductibles, copays, and benefits directly from within the workflow. The solution connects to over 1,500 payers and supports both single-patient and batch verifications to streamline revenue cycle management. It helps reduce claim denials by automating pre-visit eligibility confirmation and integrating seamlessly with billing processes.

DrChrono is a cloud-based EHR and practice management platform that includes integrated eligibility verification tools, enabling real-time checks of patient insurance coverage and benefits using ANSI X12 270/271 transactions. It supports both individual and batch verifications across major payers, helping practices reduce claim denials by confirming eligibility before services. The feature seamlessly integrates with scheduling, billing, and patient portals for efficient revenue cycle management.