Eligible develops a REST API aimed at standardizing and simplifying health insurance eligibility requests and related insurer transactions for health tech applications. Its APIs communicate with more than 1,000 health insurance companies and support eligibility, policy, coverage, demographics, authorizations, coordination of benefits, claims, payments and more. The company charges a scaling fee—five cents per transaction for the first 250,000 hits—with per-transaction pricing that drops as usage increases. Eligible counts practice management system Kareo as one of its largest customers and works with Remedy Partners, RadNet, Simplee, and EveryMove. The company is a graduate of accelerators including Y Combinator and Rock Health and says it has direct integrations with over 90% of U.S. insurers. According to an SEC filing, Eligible raised $2.3 million; it had previously raised more than $1.5 million in seed funding last year via AngelList and SecondMarket, though the filing is unclear on whether that prior amount is included. Eligible builds a modern, standardized stack of REST APIs to aggregate and normalize healthcare eligibility, coverage and patient data across legacy systems. The platform lets developers and providers confirm active insurance coverage, retrieve demographics and plan details, and electronically request pre-authorization codes. Eligible is already processing roughly 8,000 eligibility transactions per day and charges five cents per transaction, generating revenue. The company reports integrations with more than 100 providers and healthcare companies and working with 60 percent of hospitals, and says adoption is growing quickly. Eligible graduated from Y Combinator and later joined Rock Health’s accelerator as it continues to expand its healthcare information-exchange platform.

Total raised

$3M

Funding rounds

2

Latest round

Equity

Latest activity

Feb 2015