The right plan for every stakeholder
Individual providers, health systems, payors, networks, and CVOs — each with a plan built around your workflow. BAA included on every plan.
Individual Provider
For independent physicians, NPs, PAs & allied health
Profile, licenses, payor enrollments, exclusion monitoring — managed in one place.
Basic
- ✓Provider profile (NPI, licenses)
- ✓3 payor enrollments
- ✓Basic OIG/SAM exclusion monitoring
- ✓1 organisation affiliation
- ✓License expiry alerts
- ✓HIPAA BAA included
Professional
- ✓Everything in Basic
- ✓Unlimited payor enrollments
- ✓DEA registration tracking
- ✓Board certifications
- ✓Medicare enrollment
- ✓MIPS tracking
- ✓Unlimited affiliations
- ✓CAQH integration
- ✓Priority support
Health System / Practice
For medical groups, hospitals, MSOs & multi-site practices
Full PSV automation, payor connections, and compliance reporting at scale.
Starter
Up to 5 providers
- ✓Core credentialing workflow
- ✓Basic primary source verification
- ✓2 payor connections
- ✓OIG/SAM monitoring
- ✓Medicare enrollment tracking
- ✓HIPAA BAA included
- ✓99.5% SLA
Professional
Up to 50 providers
- ✓Full PSV automation
- ✓Unlimited payor connections
- ✓OIG/SAM exclusion monitoring
- ✓CAQH integration
- ✓Re-credentialing lifecycle
- ✓Advanced analytics & reports
- ✓API access
- ✓99.5% SLA
Enterprise
Unlimited providers
Est. $35–50/provider/month
- ✓Everything in Professional
- ✓SSO / SAML
- ✓CVO delegation
- ✓MIPS / MACRA reporting
- ✓Dedicated infrastructure
- ✓White-glove onboarding
- ✓99.9% SLA guarantee
Health Plan / Payor
For insurance carriers, managed care & Medicare Advantage plans
Credentialing queue, provider directory, FHIR R4 APIs, and CMS compliance — all in one platform.
Standard
Up to 500 contracted providers
- ✓Credentialing queue management
- ✓Provider directory
- ✓OIG/SAM monitoring (all contracted providers)
- ✓Network adequacy tracking
- ✓FHIR R4 patient access API (CMS)
- ✓1 network product
- ✓Advanced analytics
- ✓99.5% SLA
Enterprise
Unlimited providers
Est. $8,000–25,000/month
- ✓Everything in Standard
- ✓Unlimited providers & networks
- ✓Payer-to-payer FHIR API
- ✓NCQA reporting
- ✓HITRUST-aligned controls
- ✓CVO delegation
- ✓SSO / SAML
- ✓Dedicated infrastructure
- ✓Dedicated support
- ✓99.9% SLA guarantee
Provider Network
For ACOs, IPAs, CINs & network management organisations
Participation management, directory accuracy, and CMS network adequacy tracking.
Standard
Up to 300 participating providers
- ✓Provider participation management
- ✓Directory accuracy tools
- ✓Network adequacy metrics (CMS)
- ✓OIG/SAM monitoring
- ✓Adequacy reporting
- ✓Advanced analytics
- ✓99.5% SLA
Enterprise
Unlimited providers · Multi-geography
Est. $5,000–15,000/month
- ✓Everything in Standard
- ✓Unlimited providers
- ✓CMS network adequacy tracking
- ✓Multi-geography management
- ✓SSO / SAML
- ✓Dedicated infrastructure
- ✓99.9% SLA guarantee
Payor + Network bundle: 15% off when taken together. Contact sales.
Credentials Verification Organisation
For NCQA- and URAC-accredited CVOs
Delegated credentialing across multiple client organisations and payors — with white-label options.
Professional
Up to 10 clients
- ✓Full credentialing per client
- ✓Cross-client credentialing queue
- ✓PSV automation
- ✓NCQA/URAC accreditation tracking
- ✓Delegation agreement management
- ✓Advanced analytics & reporting
- ✓API access
- ✓99.5% SLA
Enterprise
Unlimited clients
Est. $500–600/client/month
- ✓Everything in Professional
- ✓Volume discount
- ✓White-label portal
- ✓SSO / SAML
- ✓Dedicated infrastructure
- ✓Consolidated reporting
- ✓99.9% SLA guarantee
Discounts & add-ons
2 months free when you pay annually. Applies to all subscription tiers.
Take Payor and Network together under one contract and receive 15% off both.
Health system adding individual provider licences. 10% off the organisation tier.
Usage add-ons (available on Professional & Enterprise)
Frequently asked questions
What's included in the free trial?
14 days, full feature access for your chosen tier. No credit card required. A BAA is still executed during the trial — HIPAA compliance is mandatory regardless of billing status. At end of trial, billing begins or the account suspends with a 30-day data export window.
What is a BAA and why does every plan include one?
A Business Associate Agreement is legally required under HIPAA before any Protected Health Information enters the system. Clarvera executes BAAs electronically during onboarding for every customer — trial or paid. No workarounds, no exceptions.
How is PHI stored and who can access it?
Each tenant's PHI is encrypted with a dedicated AWS KMS key unique to your organisation. Clarvera staff cannot decrypt your PHI without a break-glass authorization tied to an open support ticket — every access is logged and reported to your admin.
How does OIG/SAM exclusion monitoring work?
Every provider is checked against OIG LEIE and SAM.gov monthly — a CMS requirement for Medicare/Medicaid billing. Matches alert your credentialing team immediately and flag the provider for coordinator review. All checks are logged for 6 years per HIPAA §164.530(j).
Can I change plans?
Yes. Upgrades take effect immediately. Downgrades take effect at end of current billing period. All data is preserved — no records deleted on downgrade. If a downgrade would exceed provider or client limits, reduce your roster first.
Where is data stored?
Data is stored in your selected US region (US-EAST-1 or US-WEST-2) and never transferred across regions. Your encryption key is rotated annually. Sub-processors are documented and kept to a minimum.
Start your 14-day free trial today
No credit card. BAA signed before any PHI enters the system.