# pVerify

**Canonical:** https://apis.io/providers/pverify/  
**Website:** https://www.pverify.com  
**APIs profiled:** 13

pVerify is a US healthcare insurance eligibility and revenue-cycle API company, part of DoseSpot (now Interra Health). Its REST API at https://api.pverify.com exchanges X12 270/271 eligibility transactions and returns parsed, practice-type-specific benefit summaries; runs 276/277 claim status inquiries; discovers unknown active coverage for self-pay patients; looks up Medicare Beneficiary Identifiers; validates patient demographics; publishes a supported-payer catalog with live per-payer up/down status; and estimates patient financial responsibility at the point of service. Authentication is an OAuth2 client-credentials bearer token plus a case-sensitive Client-API-Id header. pVerify publishes no OpenAPI — its machine-readable contract is a public Postman Collection v2.0.0 at https://postman.pverify.com/, from which the OpenAPI documents in this repository were derived operation-for-operation.

## Kin Score — 56.5 / 100 (strong)

Scored 2026-08-25 under rubric 0.14.0. Trend: flat (-0.8 from 57.3).

| Facet | Score |
|---|---|
| Discoverability | 74.1 |
| Contract Quality | 62.6 |
| Governance | 45.5 |
| Contract Governance | 45.5 |
| Operational Transparency | 34.2 |
| Developer Ergonomics | 49.4 |
| Commercial Clarity | 61.8 |
| Access Clarity | 61.8 |

Regulatory layer — **Health**: 27.5 (matched via tags).

## Agent readiness — 32.9 (agent-ready)

| Dimension | Value |
|---|---|
| Spec Presence | yes |
| Agentic Access | derived |
| Reversibility Documented | no |
| MCP Server | no |
| Auth Clarity | bearer |
| Idempotency | no |
| Error Semantics | documented |
| OpenAPI Examples | verified |
| Rate Limit Signal | documented |
| Event Surface Described | yes |
| Agent Skills | derived |
| Well Known Catalog | no |
| Consent Identity | no |
| Agent Card | no |
| Dry Run Mode | no |
| Delegated Identity | no |
| Protected Resource Metadata | no |
| Dynamic Client Registration | no |
| Agentic Commerce | no |

## Access

Tiered subscription · Sales-led onboarding · API is an Enterprise-tier entitlement — onboarding: unknown, pricing: unknown, trial: no (confidence: high).

## APIs (13)

- **pVerify Authentication API** — OAuth2 client-credentials token endpoint. POST /Token exchanges Client_Id + Client_Secret for a bearer access_token used on every other pVerify call, alongside the case-sensitiv...
- **pVerify Eligibility API** — Real-time X12 270/271 insurance eligibility verification. Submit an EligibilitySummary inquiry, poll the pending queue, retrieve the parsed benefit summary or the raw 271, pull ...
- **pVerify Dental Eligibility API** — Dental insurance eligibility and benefit verification, including the only version-prefixed path in the pVerify surface (/api/v2/DentalEligibilitySummary) alongside the unversion...
- **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.
- **pVerify MBI Lookup API** — Look up a Medicare Beneficiary Identifier for a patient from demographic data, for providers who need the MBI before they can run Medicare eligibility.
- **pVerify Patient Demographic Validator API** — Validate and complete patient demographic data (pDV) — name, date of birth, gender and address — so that downstream eligibility and discovery inquiries match on identity.
- **pVerify Claim Status API** — X12 276/277 claim status inquiry. Ask a payer what happened to a submitted claim and retrieve the 277 response by RequestID. Not every payer supports 276/277 electronically.
- **pVerify Patient Cost Estimator API** — Estimate patient financial responsibility for a planned service from the payer benefit data, for point-of-service collection.
- **pVerify Payers API** — The payer network surface: the full supported-payer catalog, live per-payer up/down status (the only pVerify operation requiring no authentication), and recent per-payer rejecti...
- **pVerify CGX Widget API** — Provision and drive the embeddable eligibility-and-estimates widget. Setup runs against the premium portal host; CGXInquiry returns a combined estimate plus eligibility result f...
- **pVerify Same or Similar API (discontinued)** — Medicare same-or-similar DME history check. pVerify labels this product "(Discontinued)" in its own documentation while continuing to document it in full; every operation is mar...
- **pVerify CMN API (discontinued)** — Certificate of Medical Necessity lookup. Labelled "(Discontinued)" by pVerify; every operation is marked deprecated in the spec.
- **pVerify SNF API (discontinued)** — Skilled Nursing Facility stay verification. Labelled "(Discontinued)" by pVerify; every operation is marked deprecated in the spec.

## Agentic access (1)

- **Pverify Agentic Access** — 10 operations · 7 acting

## Security (3)

- **Pverify Authentication** — http/apiKey · 3 schemes
- **Pverify Domain Security** — TLSv1.3 · HSTS · DMARC
- **Pverify Trust Center** — SOC 2 Type II, HIPAA

## Plans (1)

- **Pverify Plans Pricing**

## Tags

Healthcare, Insurance, Eligibility, Claims, EDI, 270/271, 276/277, Revenue Cycle, Medicare, Payers, Insurance Discovery, Patient Estimation, HIPAA, Dental

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Profiled by [API Evangelist](https://apievangelist.com) and published on [APIs.io](https://apis.io/providers/pverify/). Scores are computed from the provider's own public artifacts under a published rubric.