Service & Price List

Contracts, Panels or Letters of interest

How much will it cost to get help to complete applications to join Insurance or EAP panels?

Medicaid or Medicaid connected plans or Applications

$250.00 + each

This includes submission & postage, tracking and signing up for various Medicare connect websites Noridian, PECOS, EDISS etc.

Processing time: About 1-2 months to a year for a decision.

General Private Insurance companies

$200.00+ each

Some companies first require a letter of interest before the Ins. Co. will extend you an application to join.

Processing time: About 90-180 days for a decision.

EAP Companies

$100.00 each

Generally these applications are not difficult and done online.

I fill out the forms and upload your documentation.

They usually do require you to build a profile with a picture.

Processing time: About 30-60 days for a decision

What is needed from the provider to start?

The National Committee for Quality Assurance (NCQA), the principal accrediting entity for Managed Behavioral Healthcare, requires intensive file review, oversight and continual monitoring of healthcare organization policies and procedures for practitioner network inclusion and maintenance. To meet this requirement, most insurance companies requires that you submit your credentialing info via CAQH. So start by getting your free account: https://proview.caqh.org/PR/Registration

What experience & coverage is needed?

The requirement varies per insurance company. But the general requirements are that you have :

2 years experience in your field (pre-license experience counts)
You are licensed with the state (in good standing)
A NPI # and are registered on NPPES https://nppes.cms.hhs.gov/
A city business license for each city you work in
Liability insurance
No felony criminal record or pending charges

Practice management or billing for Solo providers OR small GROUP practice.

How much is will this cost ?

About $200.00 to $400.00 a month

All jobs must be quoted

Guesstimate for average Solo providers with a small practice of about 15-20 active patients/clients will require about

$200-$250 a month. You pay for clearinghouse service fee.

$250- $400 for medium group with 15 employees or less producing 40 -250 claims a week

How much is the service fee?

About $39 Per NPI

Service fees are charged by the clearinghouse you use to submit the claims. In the healthcare industry, a clearinghouse is an institution that electronically transmits different types of medical claims data to insurance carriers.

Office Ally, for example, is $0 to $39.9500 a month and SimplePractice starts at $99.00 a month per NPI.

All insurance companies will give the same disclaimer "Benefits verification by phone or online is NOT a guarantee of payment or benefits. Benefits are verified when the claim is received and processed." Meaning all the information you get on the phone or online is NOT guaranteed to be true or accurate.