Or you may be interested in creating patient estimates for uninsured AND insured patients, as a number of providers are doing today. (Read how 4-hospital TeamHealth shifted to a 100% estimate model.) In the era of high-deductible health plans, most consumers today want to know their patient financial responsibility before they receive treatment.

Or now that patients account for up to 30% of provider revenue, you may be aiming to use patient estimates to collect more upfront. Every dollar collected up front is one that stays out of lagging accounts receivable.

Whichever your goal, Experian payment estimate software combines data from chargemasters, claims history, payer contracts, and insurance benefits to generate cost estimates for patients before or at the point of service.

It’s not the only or even the best patient payment estimate solution provider, however. It is one of the largest, competing with big names like Waystar, R1 RCM, RevSpring, and Cerner to serve the largest providers like hospitals and health systems. In fact, Experian provides RCM tools (estimates and/or more) to over 60% of U.S. hospitals.

While Experian is known as a leading patient estimate vendor, it may or may not fit your organization’s current needs and challenges. The variety of patient payment estimate vendors includes some that serve certain medical specialties or offer this technology as a point solution, while others want to bundle it with more RCM tools like scheduling or prior authorization automation. Here we explore the top five Experian patient estimate alternatives so you can evaluate features that match most closely with your organization’s needs. Get a good foundation of the variety of patient estimate features without the filter of a vendor’s salesperson.

Features of Experian Patient Estimate Software

Which of the features below are your must-haves? Which would be nice to have? Which can you do without?

Integration with financial assistance options -- The tool incorporates financial assistance policies for self-pay patients, including prompt-pay discounts, state-mandated discounts, and payment plans. These features help patients explore options to manage their healthcare costs effectively.

Support for multi-component procedures -- The solution allows providers to display multi-component procedures in estimates, ensuring comprehensive pricing information for complex treatments.
Customizable worklists and reporting -- Providers can customize worklists by procedure, user, or department and track productivity through robust reporting tools. This feature enhances operational efficiency and transparency initiatives.
Multi-language support -- Estimates can be printed in multiple languages, making the software accessible to diverse patient populations.
Audit trail functionality -- Account disposition notes can be added to create an audit trail, enabling providers to maintain detailed records of cost estimations for future reference or compliance purposes.
Integration with provider systems -- The software integrates with hospital EHR, PMS, finance, and billing systems. Of course, all patient estimate software should offer thorough integration. It allows providers to automate updates to price lists and access real-time benefits data for accurate estimations, critical steps in estimate generation.
Compliance with regulatory requirements -- Experian's Patient Estimates tool helps providers comply with regulations like the Price Transparency Final Rule and the No Surprises Act by automating good-faith estimates for uninsured or self-pay patients. All patient estimate platforms must offer this feature.
Mobile accessibility for patients -- Patients can access their cost estimates via mobile devices through a self-service portal. Patients appreciate convenient access to their financial obligations.

Something on this list may be your must-have. Review Experian patient estimate features and its competitors to determine where most of your must-haves exist in one vendor.

Top 5 Experian Patient Estimate Alternatives

MD Clarity

R1 RCM

WayStar

HealthMe

Zoetec

An Experian patient estimate competitor known for accuracy and integration with a broad range of payer systems

MD Clarity

In this case study, you can read how, after moving patient estimates from Experian to MD Clarity, an orthopedic MSO cut the time to generation of each estimate from five minutes to one minute. This MSO also enjoyed MD Clarity’s better, faster customer service. With Clarity Flow in place, the MSO sent 12,500 accurate surgical estimates with little staff intervention.

Founded in 2010, MD Clarity is a pioneer in the revenue cycle management software industry, offering tailored solutions to provider groups, healthcare managed service organizations (MSOs), and health systems. Its patient estimate platform, Clarity Flow, has automated hundreds of thousands of estimates for providers in all states and specialties across the U.S. It also offers contract management software RevFind.

With over a decade of expertise, the company focuses on empowering patients with clear insights into their financial responsibilities while ensuring healthcare providers receive fair compensation. MD Clarity has supported more than 3,000 facilities, 150,000 providers, and facilitated over 20 million patient encounters across the United States.

Take a quick, self-guided tour of how you can automate eligibility verification and estimate generation here:

Features Experian patient estimate platform shares with MD Clarity’s Clarity Flow

Pricing transparency -- Both platforms focus on providing accurate cost estimates to patients before or at the point of service, helping them understand their financial obligations and make informed decisions.
Automation tools, not services -- Both companies sell only their automation software. Neither offers patient estimate services carried out by onshore or offshore staff.

Integration with financial assistance options -- Each solution incorporates financial assistance policies for self-pay patients, including discounts and payment plans, ensuring affordability and compliance with regulations like the No Surprises Act.
Automation and real-time functionality -- Both systems automate processes such as insurance verification and cost estimation, leveraging real-time data to deliver precise calculations based on payer contracts and patient benefits.
Patient engagement tools -- MD Clarity and Experian enable patients to access their estimates online, empowering them to review costs and make upfront payments or deposits directly through the platform.
Compliance with regulatory requirements -- Both platforms help healthcare providers comply with price transparency regulations, such as the No Surprises Act, by generating Good Faith Estimates (GFEs) for uninsured patients.
Customizable reporting and workflows -- Both solutions provide tools for tracking productivity, customizing workflows, and managing estimate analytics, ensuring operational efficiency for healthcare providers.

These shared features highlight the extent of the work that needs to be done for patients to grasp their financial responsibility upfront.

Differences between MD Clarity’s Clarity Flow and Experian Patient Estimates

One or more of the following subtleties may make a critical difference to your physician group or MSO.

Delivery of estimates -- Clarity Flow automates the creation and delivery of patient cost estimates via email, text, or letter. Depending on the parameters set by the provider, it can also send the estimate automatically upon patient scheduling, free of staff intervention. On the other hand, Experian provides estimates through a self-service portal where patients generate their own cost breakdowns.
Customer service – MD Clarity prides itself on prompt and thorough customer service. This dedication has won it recognition from G2 as a High Performer in G2’s Summer 2024 Grid® Report. High Performers are earned based on receiving high customer satisfaction ratings compared to others in their category on G2, the world’s largest software review marketplace. It’s also won for Best Support, Best Relationship, and Easiest To Do Business With. Experian has not won similar recognition.
Upfront payment options – MD Clarity enables patients to make upfront deposits directly from their online estimates, simplifying collections and reducing administrative burden. Experian focuses on improving upfront collections but does not emphasize direct payment functionality within its estimate process.
Customization of estimate letters – MD Clarity offers tailored estimate letters that include deductibles, copays, and coinsurance, customized to individual patient details. Experian provides easy-to-understand cost breakdowns but does not highlight the same level of personalization in its estimate letters.
Multi-language support – Experian includes multi-language printing options for patient estimates to cater to diverse populations. MD Clarity does not mention multi-language capabilities in its platform features.
Compliance with regulations – MD Clarity emphasizes achieving compliance without requiring additional staffing, while Experian focuses on standardizing price transparency practices.
Automation scope MD Clarity automates eligibility verification and pre-service estimates for insured patients, ensuring hands-free operation for 99% of cases. Experian automates updates to price lists and integrates real-time benefits data but does not emphasize automation for pre-service workflows.

These differences reflect how MD Clarity prioritizes automation and operational efficiency in delivering patient estimates, while Experian focuses more on accessibility and compliance through self-service tools.

Ratings

Technology career board Built-In recognized MD Clarity as a Best Place to Work in Seattle. MD Clarity appears on Inc. Magazine’s 2024 list of the 5000 fastest-growing private companies in America.

On G2, MD Clarity has earned an average of 4.2 / 5 stars from 31 reviews.

An Experian patient estimate competitor offering software + services

R1 RCM

R1 RCM is a large provider of end-to-end revenue cycle management (RCM) solutions. At the same time it allows healthcare organizations to leverage modular solutions for specific needs rather than adopting the full end-to-end suite.

Where R1 RCM and Experian patient estimate platforms diverge

Structure -- Unlike Experian and MD Clarity, which offer automated platforms, R1 RCM combines its platforms with expert services to conduct revenue cycle tasks, including patient estimates. Using offshore staffing solutions in countries like India and the Philippines, it promises scalability and global delivery. Of course, because services are conducted by humans, R1 RCM will be more costly than Experian and MD Clarity. Further, R1 RCM integrates patient estimates into its broader Entri™ patient access solution, which also includes scheduling, registration, clearance, intake, and payment. In contrast, Experian offers a dedicated patient estimate platform that focuses specifically on generating accurate cost estimates using data from chargemasters, claims history, payer contracts, and insurance benefits.

Advanced technology -- Both platforms leverage automation, but R1 RCM emphasizes robotic process automation and machine learning to refine workflows and reduce revenue leakage. Experian focuses on automating updates to price lists and integrating real-time benefits data for accurate estimates.

Financial assistance integration -- Experian incorporates financial assistance options such as prompt-pay discounts, state-mandated discounts, and payment plans directly into its patient estimate tool. R1 RCM does not emphasize financial assistance integration within its estimation features. Instead, it supports overall patient financial care through its Entri™ platform.

Multi-language support -- Experian’s patient estimate platform includes multi-language printing options to cater to diverse patient populations. R1 RCM does not explicitly mention multi-language capabilities in its patient estimation tools.

Scalability -- Both platforms are scalable for healthcare organizations of varying sizes. However, R1 RCM emphasizes serving large health systems with complex needs through its comprehensive end-to-end solutions, while Experian highlights flexibility in deploying its standalone tools across hospitals, health systems, and physician practices.

These differences reflect how R1 RCM integrates patient estimates into a broader workflow with advanced automation technologies, while Experian provides a focused solution designed for accessibility and compliance with price transparency regulations.

These critical differences emphasize how it takes careful research to find the right patient estimate functionalities to meet your patient population, location, and even brand needs.

At this time, there are no reviews for R1 RCM on G2, Software Advice, Software Finder, or Capterra.

An Experian patient estimate alternative with end-to-end RCM solutions

Waystar

Waystar was founded in 2017 from the convergence of two long-time RCM leaders, ZirMed and Navicure. The company is well-known for running a respected claims clearinghouse.

An end-to-end healthcare revenue cycle management platform that leverages AI, automation, and advanced analytics, Waystar offers patient estimates in addition to a variety of front and back end RCM automation. Serving hospitals, health systems, physician practices, and multi-specialty organizations, Waystar supports over 1 million providers and reaches 50% of the U.S. patient population. Its scalability and automation capabilities also make it particularly suitable for large health systems seeking efficiency gains.

Waystar’s patient estimate platform provides accurate, real-time cost estimates for patients. As with all patient payment estimates, it leverages enriched benefit data through advanced technologies like Electronic Data Interchange (EDI) and Robotic Process Automation (RPA) to calculate patient liabilities without manual intervention.

The platform supports out-of-network benefit estimation, delivers user-friendly and easy-to-understand estimates, and scales efficiently for organizations of all sizes.

Waystar’s ability to integrate seamlessly with its own complementary solutions like eligibility verification and propensity-to-pay analytics means it provides a comprehensive approach lacking in point solution vendors. However, most healthcare organizations have existing eligibility verification and other RCM automation platforms performing various RCM tasks. Providers satisfied with legacy solutions often prefer a point patient estimate solution, implementing it as a bolt-on.

Despite billing itself as an end-to-end RCM solution, Waystar’s patient estimation solution can be used as a standalone module. This flexibility allows healthcare organizations to integrate the estimator with their existing systems without adopting Waystar’s full suite of services.

Similarities between Waystar and Experian patient estimates

Here are the similarities between Waystar and Experian's patient estimate platforms:

Accurate, Real-Time Estimates -- Both Waystar and Experian provide highly accurate, real-time patient payment estimates by integrating data such as insurance benefits, payer contracts, and provider pricing. This ensures patients receive precise cost breakdowns before or at the point of service.
Automation -- Both platforms automate the estimation process to reduce manual intervention, improving staff efficiency. Waystar uses technologies like EDI (Electronic Data Interchange) and RPA (Robotic Process Automation), while Experian automates updates to price lists and generates estimates based on real-time data.

Compliance with regulations -- Both solutions help healthcare providers comply with the No Surprises Act and other price transparency regulations by generating Good Faith Estimates (GFEs) for uninsured or self-pay patients.

Patient engagement -- Waystar and Experian both focus on enhancing patient engagement by providing clear, easy-to-understand cost estimates. They empower patients to make informed financial decisions, improving satisfaction and trust.

Financial assistance integration -- Both platforms incorporate financial assistance policies, such as prompt-pay discounts, state-mandated discounts, and payment plans, to make healthcare costs more manageable for patients.

Scalability -- Waystar and Experian's solutions are scalable, making them suitable for healthcare organizations of varying sizes, from small practices to large health systems.

These shared features underscore their commitment to improving price transparency, streamlining workflows, and enhancing the patient financial experience.

Differences between Waystar and Experian patient estimates

Automation and accuracy -- Waystar places a strong emphasis on automation, leveraging technologies like Electronic Data Interchange (EDI) and Robotic Process Automation (RPA). It continuously refines its algorithms to ensure precision, including support for out-of-network benefit estimation, which is particularly useful for providers handling complex payer scenarios. In contrast, Experian automates updates to price lists and uses real-time benefits data to deliver accurate estimates but does not emphasize advanced automation technologies or out-of-network estimation capabilities.

Out-of-network estimation -- Waystar offers robust support for out-of-network benefit estimation, making it particularly valuable for providers dealing with complex payer scenarios. Experian, on the other hand, primarily focuses on generating estimates based on in-network contracts and benefits, with less emphasis on out-of-network scenarios.

Self-service options -- Experian offers a self-service portal that allows patients to generate their own cost estimates using insurance or self-pay information, empowering them to take control of their financial decisions. Waystar focuses on providing user-friendly estimates designed for staff to confidently discuss costs with patients at the point of service but does not highlight a dedicated self-service option for patients.

Multi-language support -- Experian includes multi-language printing options for cost estimates, improving accessibility for diverse patient populations. Waystar does not emphasize multi-language support in its patient estimate platform.

These differences illustrate how Waystar prioritizes advanced automation and scalability for operational efficiency, while Experian focuses more on accessibility features like self-service portals and multi-language support to enhance the patient experience.

Waystar has a 4.4 star rating on G2 from 117 reviews.

An Experian patient estimate competitor that serves smaller practices and physician groups

HealthMe

Founded in 2016 by a physician, HealthMe is a specialized revenue cycle management platform designed to serve self-pay patients and the specialty physician groups that accept those payments. Unlike the other alternatives listed here, its only product is its patient payment estimate platform, making it a single-point solution.

HealthMe focuses exclusively on direct-pay markets, offering an online marketplace where patients can compare bundled healthcare services and generate good faith estimates in compliance with the No Surprises Act. Its platform eliminates the need for insurance involvement, allowing patients to pay upfront while simplifying workflows for providers.

HealthMe and Experian patient estimate platform differ in these ways

These two companies are very different, mostly in size and ability to scale.

Target market -- HealthMe focuses exclusively on self-pay patients and specialty physician groups, offering a marketplace for bundled healthcare services without involving insurance. In contrast, Experian caters to a broader market, including hospitals, health systems, and physician practices, integrating insurance-based estimates alongside self-pay options.
Scope of services -- HealthMe is narrowly focused on direct-pay solutions, allowing patients to compare prices and pre-pay for services. Experian provides a more comprehensive suite of tools, including financial assistance integration, propensity-to-pay analytics, and Medicaid enrollment support, making it suitable for diverse patient populations.
Self-service features -- HealthMe allows patients to generate Good Faith Estimates (GFEs) online but does not automate sending estimates. Experian offers more robust self-service capabilities through its PatientSimple portal, enabling patients to generate estimates, set up payment plans, and access financial counseling.
Automation -- While both platforms automate GFE generation, Experian automates updates to price lists and integrates real-time benefits data for highly accurate estimates. HealthMe’s automation is more limited and tailored specifically to the needs of self-pay patients.
Compliance tools -- Both platforms comply with the No Surprises Act; however, Experian’s broader compliance tools include features like consistent pricing policies and tracking potential versus actual collections. HealthMe focuses solely on ensuring compliance for self-pay GFEs.

These differences highlight how HealthMe is designed for niche markets prioritizing direct-pay simplicity, while Experian offers a more extensive solution for healthcare organizations seeking comprehensive revenue cycle management tools.

An Experian patient estimate alternative known for accuracy and integration with a broad range of payer systems

Zotec

Zotec Partners, founded in 1998, serves over 25,000 healthcare clinicians and processes more than 120 million medical encounters annually, focusing on hospitals, specialty physician practices, and outpatient services. Zotec combines advanced technology, including its proprietary Electronic Billing Center (EBC), with client-focused service to optimize billing, patient payments, and practice management.

Unlike larger RCM companies like Experian and Waystar, which offer broad end-to-end solutions across the healthcare spectrum, Zotec emphasizes a personalized approach with tailored services for specific provider groups. Its innovative tools, such as the ZiGO (Zotec Intelligent Guarantor Outreach) solution, prioritize compassionate patient experiences while maximizing provider collections.

Zotec Partners comprehensive suite of revenue cycle management (RCM) products including:

Patient Financial Experience Platform – provides clear cost estimates, flexible payment options, and personalized financial communication.

Time of Service Tool – uses eligibility and estimation algorithms to predict patient payment responsibilities

The Z-TOSS Portal – analyzes payer payment history and calculates patient co-insurance amounts.

Zotec end-to-end RCM solutions integrate front-end and back-end processes such as claims management, billing, and patient engagement. It combines software with services, offering custom-built systems tailored to specific provider needs. It has some onshore resources to carry out provider RCM work.

Similarities between Zotec's Patient Financial Experience platform and Experian's

Upfront cost estimations -- Both platforms provide patients with accurate, upfront cost estimates by leveraging technology to calculate deductibles, out-of-pocket costs, and remaining balances. This ensures financial transparency before services are rendered.
Patient engagement and convenience -- Zotec and Experian focus on enhancing the patient experience by offering user-friendly platforms that allow patients to access their financial information, create payment plans, and make payments easily. Zotec’s platform includes mobile convenience and real-time chat support, while Experian offers multi-language support and customizable scripts for staff communication.
Integration with provider systems -- Both solutions integrate with hospital information systems or practice management systems to streamline workflows and ensure seamless access to billing and estimate data.
Compliance with price transparency regulations -- Each platform supports compliance with regulations like the No Surprises Act by providing clear cost estimates for uninsured or self-pay patients.
Flexible payment options -- Both platforms enable patients to set up payment plans or pay balances through various methods, improving collections and reducing financial friction.

These shared features highlight how both Zotec and Experian usher healthcare organizations into the digital era with robust patient estimate platforms.

Differences between Zoetec and Experian patient estimate platforms

Target audience -- Zotec primarily focuses on specialty physician practices and outpatient providers. Experian, on the other hand, serves a broader range of healthcare organizations, including hospitals, health systems, diagnostic services, and pharmacies.

Patient engagement features -- Zotec emphasizes a highly interactive patient experience with features like mobile scheduling, text message alerts, live customer service, and consolidated statements. Experian offers patient engagement tools such as multi-language support, customizable scripts for staff communication, and self-service portals for generating estimates, but does not highlight mobile-centric engagement features like Zotec.

Scope of automation -- Both platforms automate cost estimation processes, but Zotec leverages additional tools like propensity-to-pay analytics to predict payment likelihood and optimize collections. Experian focuses more on integrating real-time benefits data and automating updates to price lists for accurate estimates.

Integration capabilities -- Experian integrates its patient estimate platform with hospital information systems and practice management systems to streamline workflows across large healthcare organizations. Zotec also offers integration capabilities but emphasizes creating interoperable systems that consolidate fragmented platforms like EMRs and payer services for smaller provider groups.

Compliance Focus -- Experian heavily emphasizes compliance with regulations such as the No Surprises Act by generating good faith estimates for uninsured or self-pay patients. Zotec also supports transparency but focuses more on simplifying billing conversations and upfront collections rather than regulatory compliance tools.

Technology Platform -- Zotec’s platform includes advanced features like real-time analytics and intelligently timed claim holds to maximize reimbursement opportunities. Departing from these targets, Experian focuses on providing accurate estimates through data integration but does not highlight advanced claim management features like Zotec.

These differences illustrate how Zotec prioritizes personalized patient engagement and tailored solutions for smaller providers, while Experian offers a more standardized approach designed for larger healthcare organizations seeking broad compliance and integration capabilities.

Zotec has received a Net Promoter Score (NPS) of -60 on Comparably, which indicates a high level of dissatisfaction among customers. No Zotec reviews appear on G2, Software Advice, or Capterra.

MD Clarity’s patient estimate solution shoulders your pricing transparency

Of all Experian alternatives and competitors, MD Clarity has the most accurate, extensive patient estimate platform – Clarity Flow. But working with MD Clarity involves more than just a new software platform. Our award-winning customer support and quarterly business review meetings help ensure providers understand every step of the patient estimate process, navigate their unique challenges, and capture opportunities with the best revenue potential.

From eligibility to automated send upon scheduling, Clarity Flow streamlines and eases the patient estimate process, relieving staff and preparing patients for their financial responsibility.

Curious as to how MD Clarity stacks against Experian? Schedule a demo today!

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