Healthcare RCM / Billing
API analysis for revenue-cycle platforms like Phreesia, Quadax, and Inovalon. A well-designed API could pull claims, remits, and eligibility responses, push statuses and appeals, and reconcile payments without clearinghouse portals.
Docs in this category
waystar
Waystar API
Waystar provides a unified revenue cycle and clearinghouse platform for healthcare providers. This page is an independent design exercise that asks what a well-designed Waystar API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
availity
Availity API
Availity is one of the largest healthcare clearinghouses and provider portals, enabling secure, compliant data exchange between payers and providers. This page is an independent design exercise that asks what a well-designed Availity API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
drfirst
DrFirst API
DrFirst is a healthcare technology company that centralizes medication management and clinical communication across providers, pharmacies, payers, and patients. This page is an independent design exercise that asks what a well-designed DrFirst API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
office ally
Office Ally API
Office Ally provides a nationwide clearinghouse, practice management (Practice Mate), cloud EHR (EHR 24/7), patient portal (Patient Ally), and related RCM tools that help practices submit claims, check eligibility, receive ERAs, and manage daily operations. This page is an independent design exercise that asks what a well-designed Office Ally API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
athenacollector
athenaCollector API
athenaCollector is athenahealth's revenue cycle management and practice management product and the financial backbone of the athenaOne suite, alongside athenaClinicals (EHR) and athenaCommunicator (patient engagement). This page is an independent design exercise that asks what a well-designed athenaCollector API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
eligible
Eligible API
Eligible is a developer-first insurance billing API platform for healthcare businesses. This page is an independent design exercise that asks what a well-designed Eligible API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
covermymeds
CoverMyMeds MCP Server
This page is an independent design exercise that asks what an MCP server for CoverMyMeds could look like: the tools it would expose, the authentication it would need, and the agent workflows it could unlock. Below: the technical requirements a production implementation would face, the use cases agent access could serve, and where to start if your team needs this kind of access today.
instamed
InstaMed MCP Server
This page is an independent design exercise that asks what an MCP server for InstaMed could look like: the tools it would expose, the authentication it would need, and the agent workflows it could unlock. Below: the technical requirements a production implementation would face, the use cases agent access could serve, and where to start if your team needs this kind of access today.
office ally
Office Ally MCP Server
This page is an independent design exercise that asks what an MCP server for Office Ally could look like: the tools it would expose, the authentication it would need, and the agent workflows it could unlock. Below: the technical requirements a production implementation would face, the use cases agent access could serve, and where to start if your team needs this kind of access today.
change healthcare
Change Healthcare MCP Server
This page is an independent design exercise that asks what an MCP server for Change Healthcare could look like: the tools it would expose, the authentication it would need, and the agent workflows it could unlock. Below: the technical requirements a production implementation would face, the use cases agent access could serve, and where to start if your team needs this kind of access today.
optum
Optum MCP Server
This page is an independent design exercise that asks what an MCP server for Optum could look like: the tools it would expose, the authentication it would need, and the agent workflows it could unlock. Below: the technical requirements a production implementation would face, the use cases agent access could serve, and where to start if your team needs this kind of access today.
availity
Availity MCP Server
This page is an independent design exercise that asks what an MCP server for Availity could look like: the tools it would expose, the authentication it would need, and the agent workflows it could unlock. Below: the technical requirements a production implementation would face, the use cases agent access could serve, and where to start if your team needs this kind of access today.
waystar
Waystar MCP Server
This page is an independent design exercise that asks what an MCP server for Waystar could look like: the tools it would expose, the authentication it would need, and the agent workflows it could unlock. Below: the technical requirements a production implementation would face, the use cases agent access could serve, and where to start if your team needs this kind of access today.
rivet health
Rivet API
Rivet provides revenue acceleration and contract intelligence for healthcare organizations. This page is an independent design exercise that asks what a well-designed Rivet API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
r1 rcm
R1 RCM API
R1 RCM is a leading revenue cycle management platform and services partner for hospitals, health systems, and physician groups. This page is an independent design exercise that asks what a well-designed R1 RCM API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
optum
Optum API
Optum (a UnitedHealth Group company) provides payer and health system technology spanning authorization management, eligibility verification, provider directory and enrollment, claims submission and remittance, analytics, and in some state programs, EVV connectivity for home and community-based services. This page is an independent design exercise that asks what a well-designed Optum API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
instamed
InstaMed API
InstaMed (a J.P. This page is an independent design exercise that asks what a well-designed InstaMed API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
healthpay24
HealthPay24 API
HealthPay24 provides a patient financial engagement platform used by provider groups, hospitals, and integrated delivery networks to modernize bill presentment and payments. This page is an independent design exercise that asks what a well-designed HealthPay24 API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
experian health
Experian Health API
Experian Health provides patient access and revenue cycle management solutions used by providers to streamline registration, verify coverage, manage authorizations, submit claims, and facilitate patient payments. This page is an independent design exercise that asks what a well-designed Experian Health API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
covermymeds
CoverMyMeds API
CoverMyMeds provides medication access solutions used by prescribers, clinics, pharmacies, payers, and manufacturers to streamline electronic prior authorization (ePA), verify pharmacy benefits, surface formulary alternatives, and coordinate specialty medication enrollments and patient assistance. This page is an independent design exercise that asks what a well-designed CoverMyMeds API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
claimlogiq
ClaimLogiq API
ClaimLogiq provides payment integrity and claim auditing solutions used by health plans, TPAs, and administrators to ensure claims are accurate, medically necessary, and compliant prior to payment. This page is an independent design exercise that asks what a well-designed ClaimLogiq API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
change healthcare
Change Healthcare API
Change Healthcare provides healthcare transaction processing and revenue cycle solutions used by provider groups, clinics, hospitals, and billing companies to exchange HIPAA EDI with payers. This page is an independent design exercise that asks what a well-designed Change Healthcare API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
cedar
Cedar API
Cedar is a patient financial engagement platform used by provider organizations and health systems to deliver clear digital billing, flexible payment options, price transparency, and pre-visit financial clearance. This page is an independent design exercise that asks what a well-designed Cedar API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
billed right
Billed Right API
Billed Right provides outsourced medical billing, coding, credentialing, and practice management services for healthcare providers. This page is an independent design exercise that asks what a well-designed Billed Right API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
accureg
AccuReg API
AccuReg provides a patient access and front-end revenue cycle platform used by hospitals and health systems to reduce denials, accelerate cash, and improve patient financial transparency. This page is an independent design exercise that asks what a well-designed AccuReg API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
gentem
Gentem API
Gentem is a healthcare revenue cycle platform and billing service for private practices. This page is an independent design exercise that asks what a well-designed Gentem API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
xifin
XiFin API
XiFin provides cloud-based revenue cycle management for diagnostic providers, independent clinical labs, hospital outreach labs, pathology groups, molecular and genomic diagnostics, toxicology, and imaging, anchored by XiFin RPM and its next-generation Empower RCM platform. This page is an independent design exercise that asks what a well-designed XiFin API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
finthrive
FinThrive API
FinThrive, formed from nThrive and TransUnion Healthcare, provides end-to-end revenue management software for hospitals, health systems, and physician practices. This page is an independent design exercise that asks what a well-designed FinThrive API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
inovalon
Inovalon API
Inovalon is a healthcare data and software company whose Provider Cloud, built on the ABILITY Network platform it acquired in 2018, powers claims management, eligibility verification, and Medicare connectivity for tens of thousands of provider facilities. This page is an independent design exercise that asks what a well-designed Inovalon API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
quadax
Quadax API
Quadax is a privately held revenue cycle management company, founded in 1973 and headquartered in Middleburg Heights, Ohio. This page is an independent design exercise that asks what a well-designed Quadax API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
ssi group
The SSI Group API
The SSI Group (Mobile, AL; founded 1988) operates one of the largest hospital-focused healthcare claims clearinghouses in the US, alongside revenue cycle software for claims management, denial management, prior authorization, real-time and pre-billing eligibility, remittance management, and claims analytics. This page is an independent design exercise that asks what a well-designed The SSI Group API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
revspring
RevSpring API
RevSpring is a healthcare engagement and payment company that handles patient billing communications end to end, printed and digital statements, appointment and billing reminders, payment portals, and merchant services. This page is an independent design exercise that asks what a well-designed RevSpring API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
symplr
symplr API
symplr is an enterprise healthcare operations platform serving 9 out of 10 US hospitals and health systems and more than 400 health plans. This page is an independent design exercise that asks what a well-designed symplr API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.
phreesia
Phreesia API
Phreesia (NYSE: PHR) is a patient intake and engagement platform that digitizes registration, scheduling, digital consent forms, insurance capture, eligibility and benefits verification, and copay and balance collection for US medical groups, specialty practices, and health systems. This page is an independent design exercise that asks what a well-designed Phreesia API could look like: the resources it would expose, the authentication it would need, and the workflows it could unlock. Below: a hypothetical endpoint design, the technical requirements a production implementation would face, the use cases programmatic access could serve, and where to start if your team needs this kind of access today.