specificationVersion: '1.0'
id: candid-health-finops
name: Candid Health FinOps
description: >-
  FinOps Framework FOCUS-aligned cost and usage guidance for Candid Health API
  consumption. Candid Health uses a custom enterprise pricing model without
  published per-call costs. Cost management focuses on claim volume, API
  throughput, and RCM efficiency metrics.
url: https://candidhealth.com/integrations

billing:
  model: enterprise-contract
  visibility: private
  publicPricing: false
  contactSales: https://candidhealth.com/
  notes: >-
    Candid Health does not publish per-API-call or per-claim pricing publicly.
    All billing is via negotiated enterprise contracts tied to claim volume
    and services enabled. Customers should work with their account manager
    to understand unit economics per encounter, eligibility check, or export.

costDrivers:

  - name: Claim Volume
    description: >-
      Primary cost driver. Enterprise contracts are typically structured around
      the number of claims or encounters submitted per month. Higher claim
      volumes may trigger tiered pricing or volume discounts.
    unit: claims-per-month
    impact: high

  - name: Eligibility Check Volume
    description: >-
      Real-time eligibility verifications via Availity and Change Healthcare
      may carry per-transaction costs or be bundled within the contract.
      Batch eligibility checks reduce per-verification overhead.
    unit: verifications-per-month
    impact: medium

  - name: API Call Volume
    description: >-
      All API calls are rate-limited to 1000 requests per 10-second rolling
      window per IP. High-volume integrations consuming near the rate limit
      continuously may indicate need for architectural review.
    unit: requests-per-month
    impact: medium

  - name: Data Exports
    description: >-
      CSV export volume and frequency for claims, financial reporting, and
      reconciliation data. Large or frequent export jobs may impact
      operational costs depending on contract terms.
    unit: exports-per-month
    impact: low

  - name: Support Tier
    description: >-
      Support SLAs (ticket response times, dedicated support) may be included
      or add-on depending on contract level. SOC 1 certified environment
      compliance is included.
    unit: contract-included
    impact: low

optimization:

  - name: Batch Eligibility Checks
    description: >-
      Use the batch eligibility endpoint instead of individual checks to reduce
      total API call volume and improve throughput efficiency.
    impact: medium

  - name: Exponential Backoff
    description: >-
      Leverage SDK-native exponential backoff to avoid wasted retry calls
      and reduce unnecessary API consumption when approaching rate limits.
    impact: medium

  - name: Charge Capture Bundles
    description: >-
      Use charge capture bundle endpoints for batch claim processing rather
      than individual claim submissions to reduce per-encounter API overhead.
    impact: medium

  - name: Export Scheduling
    description: >-
      Schedule large CSV exports during off-peak hours to minimize API
      contention and optimize throughput for real-time workflows.
    impact: low

focus:
  provider: Candid Health
  serviceName: Revenue Cycle Management API
  serviceCategory: Healthcare IT / Medical Billing SaaS
  billingCurrency: USD
  billingPeriod: monthly
  invoicingMethod: contract
  chargeModel: negotiated-enterprise