pVerify Insurance Discovery API
Find unknown or unreported active insurance coverage for a patient presenting as self-pay, returning candidate payers and member IDs plus a hosted details URL and PDF report.
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OpenAPI Specification
openapi: 3.2.0
info:
title: pVerify Insurance Discovery API
description: Real-time healthcare insurance eligibility and revenue-cycle API. Derived operation-for-operation from the public Postman collection pVerify publishes at https://postman.pverify.com/ (collection 6ceb8797-50ff-42fd-98a3-64beefaa6c94, last updated 03/01/2026). Covers eligibility (270/271), dental eligibility, insurance discovery, MBI lookup, patient demographic validation, claim status (276/277), patient cost estimation, payer lists and the CGX widget.
version: '1.0'
termsOfService: https://pverify.com/privacy-policy/
contact:
name: pVerify Support
email: support@pverify.com
url: https://pverify.com/contact-support/
servers:
- url: https://api.pverify.com
description: Production
- url: https://testapi.pverify.com
description: Test environment published by pVerify
tags:
- name: Insurance Discovery
paths:
/api/InsuranceDiscovery:
post:
operationId: insuranceDiscovery
tags:
- Insurance Discovery
summary: InsuranceDiscovery
description: 'Environment |
URL |
Test |
https://testapi.pverify.com/API/InsuranceDiscovery |
Production |
https://api.pverify.com/API/InsuranceDiscovery |
pVerify’s Insurance Discovery allows Hospitals and Providers to find a patient’s insurance coverage to collect potentially millions from insurance companies, allow prompt claim submission, increase patient payment collection, and drastically decrease Account Receivables.'
requestBody:
required: true
content:
application/json:
schema:
type: object
properties:
doS_EndDate:
type: string
example: 04/28/2023
doS_StartDate:
type: string
example: 04/28/2023
patientStateId:
type: integer
example: 10
patientState:
type: string
patientSSN:
type: string
patientLastName:
type: string
example: TEST
patientFirstName:
type: string
example: TEST
patientDOB:
type: string
example: 01/01/1950
patientGender:
type: string
example: M
location:
type: string
example: CA
notes:
type: string
verifyMedicare:
type: boolean
example: false
patientHasDisability:
type: boolean
example: false
example:
doS_EndDate: 04/28/2023
doS_StartDate: 04/28/2023
patientStateId: 10
patientState: ''
patientSSN: ''
patientLastName: TEST
patientFirstName: TEST
patientDOB: 01/01/1950
patientGender: M
location: CA
notes: ''
verifyMedicare: false
patientHasDisability: false
responses:
'200':
description: OK
security:
- bearerAuth: []
clientApiId: []
/api/GetInusuranceDiscoverySummaryResponse/{requestId}:
get:
operationId: getInsuranceDiscoverySummaryResponse
tags:
- Insurance Discovery
summary: InsuranceDiscovery GET
description: 'Environment |
URL |
Test |
https://testapi.pverify.com/API/GetInusuranceDiscoverySummaryResponse/{id} |
Production |
https://api.pverify.com/API/GetInusuranceDiscoverySummaryResponse/{id} |
GetInusuranceDiscoverySummaryResponse returns the response from the InsuranceDiscovery POST call using a unique request id provided in the InsuranceDiscovery response.
Headers
Key |
Value |
URL |
https://api.pverify.com/API/GetInusuranceDiscoverySummaryResponse/{id} |
Method |
GET |
Headers |
Description |
Authorization |
Authorization token from above preceded by the String "Bearer" |
Client-API-Id* |
Your pVerify client-api-id |
Client-API-Id |
API ID provided by pVerify |
Content-Type |
application/json |
URL Parameters |
RequestId returned in InsuranceDiscovery response |
*Note: The Client-API-Id header is required. Header keys are case sensitive.
GetInusuranceDiscoverySummaryResponse Response Fields
See InsuranceDiscovery response.'
parameters:
- name: requestId
in: path
required: true
schema:
type: string
description: Unique pVerify transaction / request id returned by the matching inquiry call.
responses:
'200':
description: OK
security:
- bearerAuth: []
clientApiId: []
/API/GetInsuranceDiscoveryDetailsURL/{requestId}:
get:
operationId: getInsuranceDiscoveryDetailsUrl
tags:
- Insurance Discovery
summary: ID Details URL
description: 'Environment |
URL |
Test |
/API/GetInsuranceDiscoveryDetailsURL/{id} |
Production |
/API/GetInsuranceDiscoveryDetailsURL/{id} |
This GET method will return details URL with Insurance Discovery Request ID as a parameter.
GetInsuranceDiscoveryDetailsURL Request
Key |
Value |
URL |
/API/GetInsuranceDiscoveryDetailsURL/{id} |
Method |
GET |
Headers |
Description |
Authorization |
Authorization token from above preceded by the String "Bearer" |
Client-API-Id* |
Your pVerify client-api-id |
Content-Type |
application/json |
*Note: The Client-API-Id header is required. Header keys are case sensitive.
GetInsuranceDiscoveryDetailsURL Resposne
Key |
Value |
isDetailsURLGenerated |
True or false |
url |
string URL |
errorMessage |
Message when isDetailsURLGenerated is false |
JSON Response
{
"isDetailsURLGenerated": true,
"url": "https://premium.pverify.com/Details",
"errorMessage": null
}'
parameters:
- name: requestId
in: path
required: true
schema:
type: string
description: Unique pVerify transaction / request id returned by the matching inquiry call.
responses:
'200':
description: OK
security:
- bearerAuth: []
clientApiId: []
/PDFReport/InsuranceDiscovery/{id}:
get:
operationId: getInsuranceDiscoveryReport
tags:
- Insurance Discovery
summary: Insurance Discovery Report
description: 'This returns a PDF report of the Insurance Discovery request.
Note two things:
The endpoint is premium.pverify.com
Authentication token is not used, instead pass your API ID and Secret.
Replace {id} with the requestid you receive from the Insurance Discovery request.'
parameters:
- name: id
in: path
required: true
schema:
type: string
description: Unique pVerify transaction / request id returned by the matching inquiry call.
responses:
'200':
description: OK
security:
- clientApiId: []
clientSecret: []
components:
securitySchemes:
bearerAuth:
type: http
scheme: bearer
description: 'OAuth2 access token returned by POST /Token, sent as `Authorization: Bearer <token>`.'
clientApiId:
type: apiKey
in: header
name: Client-API-Id
description: Client API identifier issued by pVerify. Required on every call; header keys are case sensitive.
clientSecret:
type: apiKey
in: header
name: Client-Secret
description: Client secret issued by pVerify, used by the one-step (no-token) endpoints and the premium report endpoints.