specification: API Commons Plans
specificationVersion: '0.1'
schema: https://raw.githubusercontent.com/api-evangelist/interface-research/main/schema/api-commons.yml#/$defs/Plans
provider: pVerify
providerId: pverify
created: '2026-06-21'
modified: '2026-08-15'
generated: '2026-08-15'
method: searched
source: https://pverify.com/pricing/
plan_count: 8
currency: USD
billing_period: month
contract_term: 1 year
reconciled: false
tags:
- Healthcare
- Insurance
- Eligibility
- Claims
- EDI
- 270/271
- Plans
description: >-
  CORRECTED 2026-08-15. Earlier rounds of this artifact recorded pVerify as sales-led with no
  published pricing. That is wrong: pVerify publishes a real per-product rate card at
  https://pverify.com/pricing/, with two named tiers per product, a monthly floor price and an
  included monthly transaction quota on each. Four products are priced — Advanced Eligibility,
  Insurance Discovery, MBI Lookup and Claim Status — for eight priced tiers in total, plus two
  published onboarding fees. Every price is quoted as "Starting at", so these are published FLOORS
  rather than final rates, and pVerify still quotes the actual contract. API access is the
  material tier boundary: on all four products the Standard tier is portal-only and the API is an
  ENTERPRISE-tier entitlement. Nothing on the page states an overage rate, a per-transaction rate
  beyond the bundle, a free trial, or a month-to-month option — those remain unpublished.
api_access_note: >-
  The pricing page lists "API" and "API Integrations" as Enterprise-tier features on Advanced
  Eligibility, Insurance Discovery and Claim Status. A buyer on a Standard tier gets the Premium
  Portal, not the REST API documented in openapi/. MBI Lookup does not list API on either tier.
sources:
- https://pverify.com/pricing/
- https://pverify.com/api-developers/
- https://pverify.com/request-a-demo/
- https://pverify.com/contact-support/
plans:
- id: pverify-advanced-eligibility-standard
  name: Advanced Eligibility — Standard
  product: Advanced Eligibility
  type: subscription
  api_included: false
  description: >-
    Portal-only real-time eligibility verification. No API entitlement is listed on this tier.
  entries:
  - label: Advanced Eligibility Standard
    name: advanced_eligibility_standard
    type: subscription
    metric: transactions
    limit: 500
    timeFrame: month
    geo: US
    unit: 1
    price: 'Starting at $125/month'
    price_amount: 125
    price_qualifier: starting-at
    currency: USD
    contract_term: 1 year
    userMultiplied: false
  elements:
  - name: Premium Portal
  - name: Single Process via Portal
  - name: Business Rules Engine
  - name: Basic Reporting
- id: pverify-advanced-eligibility-enterprise
  name: Advanced Eligibility — Enterprise
  product: Advanced Eligibility
  type: subscription
  api_included: true
  description: >-
    Adds the REST API, API integrations, self-service and full-service batch, and detailed
    reporting on top of the portal.
  entries:
  - label: Advanced Eligibility Enterprise
    name: advanced_eligibility_enterprise
    type: subscription
    metric: transactions
    limit: 1500
    timeFrame: month
    geo: US
    unit: 1
    price: 'Starting at $395/month'
    price_amount: 395
    price_qualifier: starting-at
    currency: USD
    contract_term: 1 year
    userMultiplied: false
  elements:
  - name: Premium Portal
  - name: API
  - name: API Integrations
  - name: Single Process
  - name: Self Batch
  - name: Full Service Batch
  - name: Business Rules Engine
  - name: Detailed Reporting
- id: pverify-insurance-discovery-standard
  name: Insurance Discovery — Standard
  product: Insurance Discovery
  type: subscription
  api_included: false
  description: Portal-only insurance discovery across commercial payers and Medicare.
  entries:
  - label: Insurance Discovery Standard
    name: insurance_discovery_standard
    type: subscription
    metric: transactions
    limit: 80
    timeFrame: month
    geo: US
    unit: 1
    price: 'Starting at $120/month'
    price_amount: 120
    price_qualifier: starting-at
    currency: USD
    contract_term: 1 year
    userMultiplied: false
  elements:
  - name: Premium Portal
  - name: Single Process
  - name: Basic Reporting
  - name: 'Searchability: Commercial Payers + Medicare (Standard)'
- id: pverify-insurance-discovery-enterprise
  name: Insurance Discovery — Enterprise
  product: Insurance Discovery
  type: subscription
  api_included: true
  description: >-
    Adds the REST API, full-service batch, detailed reporting and State Medicaid searchability.
  entries:
  - label: Insurance Discovery Enterprise
    name: insurance_discovery_enterprise
    type: subscription
    metric: transactions
    limit: 200
    timeFrame: month
    geo: US
    unit: 1
    price: 'Starting at $390/month'
    price_amount: 390
    price_qualifier: starting-at
    currency: USD
    contract_term: 1 year
    userMultiplied: false
  elements:
  - name: Premium Portal
  - name: API
  - name: Full Service Batch
  - name: Detailed Reporting
  - name: 'Searchability: Commercial Payers + Medicare + State Medicaid (Advanced)'
- id: pverify-mbi-lookup-standard
  name: MBI Lookup — Standard
  product: MBI Lookup
  type: subscription
  api_included: null
  description: >-
    Medicare Beneficiary Identifier lookup. The pricing page does not list API on either MBI tier,
    even though openapi/pverify-mbi-lookup-api-openapi.yml documents MBIInquiry / GetMBIResponse.
  entries:
  - label: MBI Lookup Standard
    name: mbi_lookup_standard
    type: subscription
    metric: transactions
    limit: 75
    timeFrame: month
    geo: US
    unit: 1
    price: 'Starting at $50/month'
    price_amount: 50
    price_qualifier: starting-at
    currency: USD
    contract_term: 1 year
    userMultiplied: false
  elements:
  - name: Business Rules Engine
  - name: Basic Reporting
- id: pverify-mbi-lookup-enterprise
  name: MBI Lookup — Enterprise
  product: MBI Lookup
  type: subscription
  api_included: null
  description: Higher MBI quota with State Medicaid access and detailed reporting.
  entries:
  - label: MBI Lookup Enterprise
    name: mbi_lookup_enterprise
    type: subscription
    metric: transactions
    limit: 200
    timeFrame: month
    geo: US
    unit: 1
    price: 'Starting at $200/month'
    price_amount: 200
    price_qualifier: starting-at
    currency: USD
    contract_term: 1 year
    userMultiplied: false
  elements:
  - name: Detailed Reporting
  - name: State Medicaid access
- id: pverify-claim-status-standard
  name: Claim Status — Standard
  product: Claim Status
  type: subscription
  api_included: false
  description: Portal-only 276/277 claim status checks.
  entries:
  - label: Claim Status Standard
    name: claim_status_standard
    type: subscription
    metric: transactions
    limit: 150
    timeFrame: month
    geo: US
    unit: 1
    price: 'Starting at $40/month'
    price_amount: 40
    price_qualifier: starting-at
    currency: USD
    contract_term: 1 year
    userMultiplied: false
  elements:
  - name: Premium Portal
  - name: Single Process
  - name: Basic Reporting
- id: pverify-claim-status-enterprise
  name: Claim Status — Enterprise
  product: Claim Status
  type: subscription
  api_included: true
  description: Adds the REST API, single/batch processing and detailed reporting.
  entries:
  - label: Claim Status Enterprise
    name: claim_status_enterprise
    type: subscription
    metric: transactions
    limit: 250
    timeFrame: month
    geo: US
    unit: 1
    price: 'Starting at $70/month'
    price_amount: 70
    price_qualifier: starting-at
    currency: USD
    contract_term: 1 year
    userMultiplied: false
  elements:
  - name: Premium Portal
  - name: API
  - name: Single/Batch Processing
  - name: Detailed Reporting
one_time_fees:
- name: Standard onboarding
  price: 'Starting at $495'
  price_amount: 495
  price_qualifier: starting-at
  currency: USD
- name: Enterprise onboarding
  price: 'Starting at $950'
  price_amount: 950
  price_qualifier: starting-at
  currency: USD
add_ons:
- name: Patient Demographic Validator (PDV)
  price: not published
  note: Listed as an optional add-on with no published price.
not_published:
- overage rate once the included monthly transaction quota is exhausted
- a pure per-transaction rate outside a bundled tier
- month-to-month (non-annual) pricing
- a free trial or self-service checkout — every CTA routes to https://pverify.com/request-a-demo/
- pricing for Dental Eligibility, Patient Cost Estimation, the CGX widget or the Payers API
notes: >-
  Prices are published floors ("Starting at"). Billing is noted as quarterly with monthly
  subscriptions available. Confirm the final rate, the overage rate and API entitlement with
  pVerify before integrating — the API is an Enterprise-tier feature on the products that list it.
maintainers:
- FN: Kin Lane
  email: kin@apievangelist.com