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As of 2026
Utilities & System Tools
Revenue: $1M-$10M ARR
Developer-friendly infrastructure APIs for instant health insurance eligibility verification.
Overview
Eligible is a cloud-based healthcare infrastructure platform providing simple, developer-friendly APIs. It establishes direct secure connectivity to health insurance data networks across the nation, converting complex legacy electronic data interchanges (EDI) into standardized JSON formats. By processing instant coverage checks, active policy checks, and accurate patient out-of-pocket estimations, Eligible empowers digital health builders to handle revenue operations smoothly.
Funding status: Funded
Revenue source: Usage-based
Customer type: B2B
Pricing: Usage-based
Tech stack: Ruby, Node.js, Go, PostgreSQL, Redis, Amazon Web Services
Platform: Web
Integrations: drchrono, Athenahealth, Elation Health, Salesforce Health Cloud, Epic Systems
Founder story
Founded in 2011 in Mountain View, California by Katelyn Gleason, Eligible was born to correct a glaring flaw in modern medicine. While working at drchrono, Gleason realized that vital operations frequently suffered because verifying policy coverage took endless manual calls. She built an automated gateway that scales healthcare data accessibility nationwide.
What it does
- Validates real-time patient insurance coverage status and plan types instantly
- Extracts accurate remaining co-insurance, co-payments, and deductible balances cleanly
- Transforms messy old legacy healthcare EDI streams into beautiful JSON payloads
- Calculates real-time clear financial responsibility estimations for scheduling systems.
Who it's for
- Digital Health Startups
- Medical Billing Networks
- Hospital IT Systems
- Electronic Health Record Providers
Why it works
- Connects developers instantly to every major health insurance entity nationwide
- Eliminates manual insurance validation calls to reduce provider wait times
- Improves upfront clinical payments by removing vague financial guess-work
- Provides rigorous HIPAA compliant data handling and data security frameworks.
Growth strategies
- Targeted developer onboarding within advanced health tech sandbox environments
- Leveraging Y Combinator cohort validation to land disruptive telemedicine startups
- Strategic platform listing alignment inside EHR marketplaces like drchrono
- Enterprise- tier custom integration expansions for massive hospital regional networks
Alternatives
Comparison overview
- Unlike horizontal digital health aggregators, Eligible focuses completely on deep billing eligibility API pipelines.
- Compared to massive multi-product platforms like Change Healthcare, Eligible provides a modern developer experience with clean JSON instead of complex legacy data setups.