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Eligible to Act as Oscar's Hosted Real-Time Eligibility Vendor, Supporting the Patient Protection Promise
[December 18, 2018]

Eligible to Act as Oscar's Hosted Real-Time Eligibility Vendor, Supporting the Patient Protection Promise

BROOKLYN, N.Y., Dec. 18, 2018 /PRNewswire/ -- Would you buy your groceries without knowing the price? How about that new pair of jeans you've been coveting for months? The answer is a resounding no! No one wants to spend their hard earned money without knowing what they are purchasing and how much it will cost them. Eligible and Oscar are asking one simple question: Why should Healthcare be any different? Eligible, the leader in Price Transparency driven health care cost estimates, is thrilled to announce that Oscar, in support of Eligible's Patient Protection Initiative, has selected Eligible as a Hosted Eligibility Vendor.

Eligible to Act as Oscar’s Hosted Real-Time Eligibility Vendor, Supporting the Patient Protection Promise

With the increasing costs of medical services, people are forgoing medical treatment in fear of how much it may cost them. Eligible is on a mission to change this by reinventing the current manual, error prone process that is used in most facilities today. It is Eligible's goal is to bring coverage and cost verification out of the stone age in order to better protect the patient from surprise medical bills and allow for greater care options.

Eligible's Hosted Eligibility Solution enables new insurers to support legacy protocols mandated for all insurers. Oscar's integration provides access to coverage and benefit information for Oscar members, which includes the information patients need to make care option decisions. Integrating Eligible's Hosted Eligibility Solution is simple for both providers and insurers alike. Providers using Eligible's platform can send eligibility and beneit requests to Oscar with no additional effort or setup. In addition, a payer can integrate with Eligible's Hosted Eligibility Solution in less than one engineer's work day. The nature of this offering provides insurers with both instant compliance and an interoperable design making it the perfect solution for new payers who may not have the time or resources to build mandated x12 interfaces.

Within days of the release of Eligible's hosted solution, Oscar's patient eligibility was set up to reach over 100,000 providers across the country including Radnet, a leading Radiology group with locations in 7 states. Radnet integrated Eligible's Oscar  solution at their 341 imaging centers to provide their patients a transparent cost estimate at the time of service. The use of Eligible's Oscar Hosted Eligibility Solution decreases the chances of surprise medical bills, thus increasing cost transparency for the patient and creating a better patient experience. It also provides a more streamlined automated option to confirm patient coverage and eligibility making it a win for both the patient and the provider.

With the help of disruptive new health insurers and patient focused Healthcare Systems, Eligible is dedicated to continuing their Patient Protection Promise Initiative. It is Eligible's goal to further revolutionize the medical billing process to ensure that no patient goes untreated due to the fear of unknown costs. There is a long battle ahead for patient cost transparency within healthcare, but Eligible is at the helm of the fight and won't give up until their mission is achieved.

About Eligible

Eligible is the leading billing infrastructure company for healthcare in the U.S. Eligible's API enables providers and other healthcare services to present patients with an easy-to-understand bill even before they enter the doctor's office. The company works with more than 2,000 insurers, covering more than 90% of the insured U.S. population, along with the country's leading healthcare providers, including Cleveland Clinic, HMS Holdings, and RadNet Radiology. Eligible's technology also powers modern healthcare services like Omada, Heal, and Carbon Health. Eligible is a New York-based company backed by more than $25 million in funding from Silicon Valley's leading investors. For more information, visit

About Oscar

Oscar, founded by Josh Kushner and Mario Schlosser, is a patient focused healthcare solution which was born out of necessity for transparency in medical billing and coverage. Currently doing business in 9 states including Ohio, New York, and California, Oscars plans cover 200,000 individuals and small businesses. Oscar's mission is not only to provide care options for their members, but to ensure that they are providing quality care options. To accomplish their goal, they have partnered with more than half of the top 20 health systems in the U.S.

Kelly Gentile


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