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How NexHealth Monetize APIs with Usage-Based API Billing and Moesif


NexHealth started as a SaaS platform that helps doctor and dentist offices grow by enabling online patient scheduling and two-way communication. As part of that solution they had to integrate with a number of Electronic Health Record (EHR) and Practice Management Systems.

A lot of API businesses follow the model of: “why should everybody build telephony - Twilio,” “why should everybody build background checks - Checkr,” or “why should everybody build search - Algolia.” A best of breed, single product can share that infrastructure across a wide variety of developers, resulting in economies of scale saving.

NexHealth realized that if they offered an API into their EHR integrations, then they could accelerate healthcare innovation for other developers, much like Plaid has done for financial systems.

NexHealth accelerates HeathTech innovation through a developer API, Plaid for electronic health records” and a SaaS offering, Shopify for doctors and dentist practices.

Paul Fung, GM of Developer APIs, NexHealth

Developers building HealthTech apps can now simply call a single API endpoint to get patient information from a large number of EHRs. Instead of building their own integrations into the disparate databases, NexHealth makes it easier for them by effectively providing a universal API for EHRs.


Reducing friction during customer acquisition is key. New patients of SmileDirectClub can book their first appointment with thousands of dentists from a single patient portal. NexHealth’s API abstracts out all of the complexity of disparate EHRs and provides a simple, live booking experience.

Smile Direct Club with NexHealth


Even though NexHealth was rapidly hiring in their engineering team, they were primarily focused on building out the core of the API and adding integrations to their SaaS product.

They didn’t have the time, nor expertise, to build a new billing system for their API; Their existing system was not appropriate, since it was for their SaaS offering. They knew that their API was going to be their growth engine moving forward, and so had to have a failsafe and reliable way to bill for usage.

Additionally, they needed insights into how their customers were using their API product, which services were popular and where they were getting into difficulty during integration.

Given engineering limitations, they also wanted to make sure that the implementation component was pretty light and simple.


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Moesif checked all the boxes:

  • Out of the box billing solution
  • Lightweight implementation
  • Deep visibility into how APIs are being used and who are using them

It took one person less than a week to integrate and fully test, after which NexHealth could bill for usage and clearly see how their API was being used.

We were soon able to start billing our customers for the API usage and it quickly became a revenue generator for us.

Paul Fung, GM of Developer APIs, NexHealth
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Multiple Monetization Options

There are a lot of different ways that NexHealth thinks about monetization. Most API businesses run some sort of usage-based model, whilst some want more predictability at higher volume. So, as a first step, NexHealth implemented two pricing models: flat rate and usage based.

Since Moesif’s API monetization solution is so flexible, NexHealth has also been testing other usage metrics for billing, some unique to HealthTech, such as:

  • How many practices are onboarded per customer?
  • How many API calls does a practice use per day?

They’ve found that depending on the use case, customers might skew towards one pricing models versus another. For instance, if a customer has many locations, but few calls, they might want to sign up to a usage-based model. Whereas, if they're going to have a ton of calls, with an unlimited number of calls per location, then they're going to adopt a usage-based model.

Moesif allows us to offer the flexibility of having API usage based, call based or really any kind of pricing model.

Paul Fung, GM of Developer APIs, NexHealth
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Deep Product Insights

As NexHealth experiences rapid growth, they’re continually looking at ways to decrease sales friction and accelerate developer onboarding as efficiently as possible.

Moesif’s ability to track adoption, identify where friction can be removed and augment CSM to make onboarding as self-serve as possible, is a key to supporting NexHealth’s developers at scale.

Upon joining NexHealth our Head of Product said ‘All right, you need to learn Moesif, because it's going to basically give you all the information you need on our API usage.’ He’s right. It gives us a lot more visibility into our API usage in a much easier way than we would have had before.

Paul Fung, GM of Developer APIs, NexHealth


When NexHealth was developing a new API product to augment its SaaS offering, they needed a way to bill customers for usage and understand how their API was performing.

Moesif presented just what they needed - Moesif API Analytics fit into their application well, it didn’t need a huge engineering lift to implement or manage, it solved their visibility needs and most importantly, it let them bill customers within a week of signing up.

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As NexHealth launched their first API product, they needed a simple way to gain insights into how their API was being used and, most importantly, bill for usage. Instead of building it themselves, they wanted a lightweight solution that could be implemented quickly and which could let them bill customers immediately.


Millions of patients everyday use NexHealth’s SaaS platform to schedule appointments and communicate with clinician offices. NexHealth also offers a developer API, exposing all of their integrations to multiple patient databases in a single endpoint. Third-party developers building HeathTech apps simply call the single API to get patient information from any number of EHRs.

Paul FungPaul Fung
General Manager of Developer API, NexHealth

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