specification: API Commons Plans
specificationVersion: '0.1'
schema: https://raw.githubusercontent.com/api-evangelist/interface-research/main/schema/api-commons.yml#/$defs/Plans
provider: Eligible
providerId: eligible
created: '2026-05-04'
modified: '2026-08-15'
generated: '2026-08-15'
method: searched
reconciled: true
source: https://eligible.com/pricing
sources:
  - https://eligible.com/pricing
  - https://eligible.com/resources/payers/coverage_passthrough.json
  - https://eligible.com/resources/payers/claims_passthrough.json
  - https://eligible.com/resources/payers/payment_status_passthrough.json
  - https://eligible.com/resources/payers/payment_reports_passthrough.json
note: >-
  REPLACES A SCAFFOLD. Until this pass the file carried the API Evangelist bulk-sweep
  defaults (Free/Professional/Enterprise, 1,000 requests a month, "TBD" prices) which
  Eligible has never published. Every value below is read from Eligible's own pricing
  page. That page is a client-rendered React app whose served HTML contains only the
  word "Pricing", so the figures were read out of the page's own JavaScript bundle
  (/assets/external-site-app-*.js, build 20260702162626, component
  app/javascript/components/PricingPage/PricingColumns.js) where the copy is present
  verbatim. Recorded as `searched` on that basis, with each string quoted below exactly
  as Eligible wrote it.
pricing_model: >-
  Transactional, pay-as-you-go, priced as a percentage of dollars remitted plus a
  per-claim fee. There are no request-quota tiers and no free tier. The two columns are
  not alternatives — the Patient Clearance price is explicitly additive to the Insurance
  Billing price ("in addition to the insurance billing cost noted to the left").
plan_count: 2
currency: USD
plans:
  - id: eligible-insurance-billing-apis
    name: Insurance Billing APIs
    type: usage-based
    description: >-
      "Access a complete insurance billing platform with simple, pay-as-you-go pricing"
    entries:
      - label: Remittance percentage
        name: remittance_percentage
        type: metered
        metric: dollars_remitted
        limit: -1
        timeFrame: usage
        geo: US
        unit: 1
        price: 1% of dollars remitted
        userMultiplied: false
      - label: Per-claim fee
        name: per_claim
        type: metered
        metric: claim
        limit: -1
        timeFrame: usage
        geo: US
        unit: 1
        price: $0.25 per claim
        userMultiplied: false
      - label: Account minimum
        name: account_minimum
        type: recurring
        metric: account
        limit: 1
        timeFrame: month
        geo: US
        unit: 1
        price: $1.00 per month
        userMultiplied: false
        note: Quoted verbatim as "- $1 per month account min fee".
      - label: Excess real-time payment status and eligibility inquiries
        name: excess_inquiries
        type: metered
        metric: transaction
        limit: -1
        timeFrame: usage
        geo: US
        unit: 1
        price: $0.05 per transaction plus applicable PTFs
        userMultiplied: false
      - label: Payer passthrough fees (PTF)
        name: passthrough_fees
        type: metered
        metric: transaction
        limit: -1
        timeFrame: usage
        geo: US
        unit: 1
        price: per-payer, see passthrough_fees below
        userMultiplied: false
    elements:
      - name: Get started in minutes
      - name: Get endless feature updates
      - name: API Powered, Rev Cycle Friendly
  - id: eligible-patient-clearance-apis
    name: Patient Clearance APIs
    type: usage-based
    description: >-
      "Access a complete patient financial clearance platform with automatic contract
      rate cleanup." Priced additively on top of Insurance Billing APIs.
    additive_to: eligible-insurance-billing-apis
    entries:
      - label: Per-claim fee
        name: per_claim_clearance
        type: metered
        metric: claim
        limit: -1
        timeFrame: usage
        geo: US
        unit: 1
        price: +$0.30 per claim (in addition to the insurance billing cost)
        userMultiplied: false
      - label: Included eligibility / cost-estimation calls
        name: included_calls
        type: quota
        metric: calls_per_claim
        limit: 10
        timeFrame: usage
        geo: US
        unit: 1
        price: '0.00'
        userMultiplied: false
        note: >-
          "Includes ten eligibility verification and/or cost estimation calls per claim."
      - label: Excess eligibility inquiries
        name: excess_eligibility
        type: metered
        metric: transaction
        limit: -1
        timeFrame: usage
        geo: US
        unit: 1
        price: $0.05 per transaction plus applicable PTFs
        userMultiplied: false
      - label: Excess cost estimates
        name: excess_cost_estimates
        type: metered
        metric: transaction
        limit: -1
        timeFrame: usage
        geo: US
        unit: 1
        price: $0.25 per transaction plus applicable PTFs
        userMultiplied: false
    elements:
      - name: Everything needed to clear patient insurance
      - name: Continuous eligibility and price estimations
      - name: Powered by AI/ML for increased accuracy
passthrough_fees:
  description: >-
    PTFs are per-payer fees Eligible passes through from the insurer, quoted on top of
    every price above. Unusually for a gated platform, Eligible publishes the full PTF
    schedule as four PUBLIC, UNAUTHENTICATED JSON documents — the same documents the
    pricing page's own PtfTable component fetches at runtime. Each row carries
    payer_ids, payer_name, pass_through_fee (USD) and effective_from. These are the
    only machine-readable price data Eligible publishes anywhere.
  probed: '2026-08-15'
  requires_referer: >-
    The CloudFront distribution answers 403 to a bare client; a browser User-Agent plus
    a Referer of https://eligible.com/pricing returns 200. An earlier round recorded
    these as unreachable for that reason.
  tables:
    - transaction: Eligibility Verifications
      url: https://eligible.com/resources/payers/coverage_passthrough.json
      status: 200
      rows: 147
    - transaction: Payment status
      url: https://eligible.com/resources/payers/payment_status_passthrough.json
      status: 200
      rows: 23
    - transaction: Payment reports
      url: https://eligible.com/resources/payers/payment_reports_passthrough.json
      status: 200
      rows: 184
    - transaction: Claims
      url: https://eligible.com/resources/payers/claims_passthrough.json
      status: 200
      rows: 278
      extra_field: claim_type (professional_claim | institutional_claim)
  fields: [payer_ids, payer_name, pass_through_fee, effective_from]
  observed_fee_range: $0.05 – $0.15 per transaction on the sampled rows
discounts:
  volume: >-
    "Volume and commitment length discounts are available. To discuss a custom package
    for your business please reach out to Eligible's customer success team."
support:
  included: >-
    "All accounts receive basic support by default. To discuss our enterprise support
    option contact us."
  plans_page: https://eligible.com/docs/support-plans/eligible-support-plans
  plans_page_status: 200 (serves the Sign In page — support-plan pricing is gated)
free_tier: false
trial: false
self_serve: false
access_note: >-
  Prices are public but the product is not self-serve. Sign-up routes to a waitlist:
  "Access to Eligible has become more exclusive. Creating an account will add your
  information to our waitlist. Gaining access may take a considerable amount of time."
  See https://eligible.com/blog/why-we-limit-access-to-our-platform-eligibles-commitment-to-real-lasting-change-in-healthcare
maintainers:
  - FN: Kin Lane
    email: kin@apievangelist.com