Eligible
Eligible provides API-based health insurance billing and eligibility verification services to healthcare businesses. The privately held Brooklyn-based company, founded in 2011 and led by CEO Katelyn Gleason, offers a Platform Services System with HITRUST and NIST certifications.
- Company typePrivate
- Founded2011
- HeadquartersBrooklyn, United States
- Headcount11–50
- GTM typeB2B
- OfferingSoftware
What Eligible does
Eligible is a private healthcare technology company that provides insurance billing APIs to healthcare businesses. Founded in 2011 and headquartered in Brooklyn, NY, the company operates an API-driven Platform Services System that handles insurance eligibility verification and billing workflows for healthcare provider and payer-adjacent customers. The company employs between 11 and 50 people and is led by founder and CEO Katelyn Gleason.
The company has secured Y Combinator backing (May 2012) and aggregate disclosed funding of approximately $25.2M across rounds spanning 2013 through 2015, with the largest raise of roughly $22.7M completed in December 2015. Eligible's Platform Services System has been independently assessed by A-LIGN and now holds HITRUST r2 Certification (covering all 19 domains) and NIST Cybersecurity Framework v1.1 Certification (covering all five CSF Core Functions), both valid through May 2028; a SOC 2 Type 2 examination is also in progress with zero readiness gaps identified. These certifications are a deliberate positioning for regulated healthcare buyers where PHI handling and audited security controls are procurement prerequisites.
No public pricing, customer logos, segment mix, or revenue figures are disclosed in the available data. The company's website (eligible.com) returned a 403 error during data collection, limiting direct visibility into product surface, GTM motion, and revenue mechanics. Based on the API-based delivery model, healthcare-billing vertical focus, and absence of disclosed enterprise pricing tiers, the business model most plausibly combines per-transaction API pricing with subscription licensing for healthcare customers integrating eligibility and claims workflows.
Eligible firmographics
Firmographics- Name
- Eligible
- Legal name
- Eligible, Inc.
- Website
- https://eligible.com
- Company type
- Private
- Founded year
- 2011
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- Eligible provides API-based health insurance billing and eligibility verification services to healthcare businesses. The privately held Brooklyn-based company, founded in 2011 and led by CEO Katelyn Gleason, offers a Platform Services System with HITRUST and NIST certifications.
- Ownership category
- akta.pro rank
Eligible industry classification
Industry- Product category
- Healthcare Insurance Billing APIs
- NAICS
- Other Insurance Related Activities (52429), Agencies, Brokerages, and Other Insurance Related Activities (5242)
- SIC
- Services-Computer Programming, Data Processing, Etc. (7370), Services-Prepackaged Software (7372)
- akta.pro primary industry
- Eligibility & Benefits Verification (HLACACAD)
- akta.pro secondary industries
- API Management & Developer Portals for Health Data (HLACABAD), Medical Coding, Billing & Clinical Documentation Support (BPAAAFAD)
Keywords
Where Eligible is headquartered
LocationHeadquarters
- HQ city
- Brooklyn
- HQ country
- United States
- HQ region
- North America
Markets served
Eligible business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Technology or R&D, Personnel, Infrastructure, Operations, Marketing or Sales
Eligible product offering
Product offeringCore offering
Eligible provides insurance billing APIs aimed at healthcare businesses, enabling programmatic eligibility verification, claims, and related billing workflows through its Platform Services System. The offering is sold as a software/API service to healthcare organizations that need to integrate insurance and billing data into their own products and operations.
Product overview
No product information available in the source data. The company website returned a 403 error page, and the provided sources do not contain details about Eligible's specific product offerings, platform architecture, or individual products and services.
Differentiator
Problem solved
Functional benefit
Products and services
- Eligible Insurance Billing API Programmatic insurance billing and eligibility verification APIs sold to healthcare businesses that need to integrate payer data and billing workflows into their own products or operations.
- Platform Services System The certified technology platform (HITRUST r2 and NIST CSF v1.1 certified, SOC 2 examination underway) that powers Eligible's healthcare insurance billing APIs and is sold as part of the overall API service to healthcare customers.
Companies that use Eligible
Customer profileIdeal customer profiles1 record
Eligible technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Eligible partnerships and signals
Strategic signalRecent moves6 records
Expansion highlights2 records
Eligible competitors and assessment
Company assessmentDirect peers
- Availity: Availity is a leading healthcare API platform for eligibility, benefits verification, prior authorization, and claims exchange between providers and payers, making it the closest direct competitor to Eligible's insurance-billing API focus.
- Waystar: Waystar offers an integrated RCM and billing platform that includes eligibility verification and patient access APIs, targeting many of the same provider customers as Eligible.
- Edifecs: Edifecs provides healthcare data exchange, X12 EDI, and interoperability solutions for payers and providers, overlapping directly with Eligible's payer-provider API focus.
- Inbox Health: Inbox Health delivers patient billing, statements, and payment-processing tools to healthcare practices, a closely adjacent billing-and-presentment workflow to Eligible's insurance billing APIs.
- HealthTrio: HealthTrio offers APIs and platforms for eligibility, benefits, claims, and member management, providing similarly API-first healthcare administrative services to Eligible.
Broad incumbents
- Change Healthcare (Optum): Change Healthcare, now part of Optum, offers a broad portfolio of RCM, eligibility, claims management, and interoperability services to payers and providers, directly overlapping with Eligible's core use cases at much larger scale.
- Experian Health: Experian Health provides eligibility verification, claims processing, and identity-management tools across the healthcare revenue cycle, competing with Eligible on payer-provider data exchange APIs.
- Trizetto (Cognizant Healthcare): Trizetto, owned by Cognizant, provides enterprise RCM and payer-provider information exchange platforms and competes with Eligible on eligibility and benefits administration at large enterprise scale.
Emerging players
- Cedar (Cedar Pay): Cedar focuses on patient billing, engagement, and financial experience, intersecting with the patient-facing side of the eligibility-and-billing workflow where Eligible also participates.
Regional players
- HealthCare.gov (CMS) marketplace glue vendors: Public-sector eligibility and enrollment systems plus their private integrator ecosystems address the same eligibility-and-benefits use case as Eligible, particularly for individual and ACA-exchange contexts.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat3 records
Key risks5 records
Key highlights5 records
Customer concentration
Eligible social profiles
Digital presenceEligible compliance and trust
Trust signalCompliance3 records
Eligible financial estimates
Financial estimateRevenue estimate
Valuation estimate
Eligible leadership team
Management profileNumber of profiles
Profiles1 record
Eligible funding detail
Funding detailFunding overview
Funding rounds5 records
Investors2 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Eligible M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Eligible
What does Eligible do?
Eligible provides insurance billing APIs aimed at healthcare businesses, enabling programmatic eligibility verification, claims, and related billing workflows through its Platform Services System. The offering is sold as a software/API service to healthcare organizations that need to integrate insurance and billing data into their own products and operations.
Is Eligible a public or private company?
Eligible is a private company. It is classified as venture growth investor backed and is currently operating.
When was Eligible founded?
Eligible was founded in 2011. It employs 11 to 50 people.
Where is Eligible based?
Eligible is headquartered in Brooklyn, United States, in the North America region.
Who are Eligible's main competitors?
Direct peers on record are Availity, Waystar, Edifecs, Inbox Health and HealthTrio. Broad incumbents are Change Healthcare (Optum), Experian Health and Trizetto (Cognizant Healthcare). Cedar (Cedar Pay) is listed as an emerging player. HealthCare.gov (CMS) marketplace glue vendors is listed as a regional player.
Does Eligible have an API?
No public API is recorded for Eligible.
What industry is Eligible in?
Eligible's product category is Healthcare Insurance Billing APIs. Its primary akta.pro industry code is HLACACAD, Eligibility & Benefits Verification, with a secondary code of HLACABAD, API Management & Developer Portals for Health Data. Its NAICS code is 52429 and its SIC code is 7370.