specification: FinOps Framework
specificationVersion: '1.0'
schema: https://www.finops.org/framework/
provider: pVerify
providerId: pverify
created: '2026-06-21'
modified: '2026-06-21'
reconciled: false
tags:
- Healthcare
- Insurance
- Eligibility
- Claims
- EDI
- 270/271
- FinOps
- Cost Management
- FOCUS
description: >-
  FinOps view of pVerify spend. pVerify bills on a sales-led, per-transaction
  model across real-time eligibility, claim status, and patient estimation
  calls, tiered by monthly volume, with batch processing for high-volume work.
  Exact per-transaction rates are not published and must be obtained from
  pVerify sales, so cost figures here are not reconciled.
notes: >-
  Per-transaction rates and volume tiers are quote-based; verify with pVerify
  sales during reconciliation.
sources:
- https://pverify.com/api-developers/
- https://www.pverify.com/rest-api/
- https://focus.finops.org/focus-specification/v1-3/
alignedWith:
  framework: FinOps Foundation Framework
  frameworkUrl: https://www.finops.org/framework/
  dataSpec: FOCUS
  dataSpecVersion: '1.3'
  dataSpecUrl: https://focus.finops.org/focus-specification/v1-3/
publisherName: pVerify
serviceCategory: Healthcare and Insurance
billingModel:
  pricingCategory: Usage-Based
  billingFrequency: Monthly
  billingCurrency: USD
  chargeCategories:
  - Usage
  - Purchase
focusColumns:
  ServiceName: pVerify API
  ServiceCategory: Healthcare and Insurance
  ProviderName: pVerify
  PublisherName: pVerify
  InvoiceIssuerName: pVerify
  BillingCurrency: USD
  ChargeCategory: Usage
  PricingCategory: Usage-Based
meters:
- name: eligibility_transactions
  description: Real-time eligibility inquiry / summary calls, billed per transaction.
  unit: transactions
  aggregation: sum
  dimensions:
  - account
  - payer
  - api
- name: claim_status_transactions
  description: Real-time 276/277 claim status inquiries, billed per transaction.
  unit: transactions
  aggregation: sum
  dimensions:
  - account
  - payer
- name: estimation_transactions
  description: Patient cost estimation calls, billed per transaction.
  unit: transactions
  aggregation: sum
  dimensions:
  - account
  - payer
- name: batch_transactions
  description: Eligibility verifications processed through the Batch API.
  unit: transactions
  aggregation: sum
  dimensions:
  - account
  - payer
principles:
- name: Visibility
  description: Track per-transaction counts by API, payer, and Client-API-Id against invoices.
- name: Allocation
  description: Tag transactions by practice/location/customer (referenceId, Location, CustomerID) to map spend to cost centers.
- name: Optimization
  description: Route high-volume verifications through the Batch API; use Eligibility Summary instead of full Inquiry where the condensed benefit set suffices; avoid redundant re-verification.
- name: Accountability
  description: Assign owners per Client-API-Id; review monthly transaction volume against contracted tiers.
maintainers:
- FN: Kin Lane
  email: kin@apievangelist.com