The ability to do real time insurance verification is usually an add on service, but would be part of the service as shown in ACUC. It is not uncommon for clearinghouses to charge in the range of 100-150 per month.
Jon knows about Office Ally. There must be a good reason for choosing a vendor other than them beside the fact that I don't think you can do real time verification with them.
Another question would be if this system can be used with other clearinghouses such as OA, which they did not discuss at ACUC.