Services & Pricing
Flat, published pricing. No percentage of your collections, no long contracts, no bundles: every enrollment is its own line, per provider. Enrollment services bill half at engagement and half at approval; CAQH and Availity bill when engaged; maintenance bills quarterly from the quarter of your first approval. If a plan's panel is closed, what you paid for that plan is refunded or credited toward another service.
| Service | What you get | Price |
|---|---|---|
| CAQH profile, new build | Created from your file: every section completed, documents uploaded, attested, with us added as an authorized user | $500 / provider |
| CAQH profile, update and attestation | An existing profile completed and corrected, documents refreshed, attested | $250 / provider |
| Medicare enrollment | PECOS enrollment or reassignment (855I, 855R, 855B as applicable) and EFT setup, followed through to approval | $500 / provider (half at engagement, half at approval) |
| Medicaid enrollment | Your state Medicaid program through its portal, followed through to approval. Each additional state is a separate enrollment; managed-care plans are commercial applications | $500 / provider / state (half at engagement, half at approval) |
| Availity setup | Registration and payer-portal linkage on Availity, which most commercial plans route enrollment and status through | $250 / provider |
| Commercial payer application | One participation application to a commercial plan, Medicaid managed-care plan or Medicare Advantage plan, followed through to approval | $200 / application / provider (half at engagement, half at approval) |
| Primary source verification | License, education, work history, and board certification verified directly with issuing sources, the standard payers and hospitals require. Scope depends on the sources involved, so each engagement is quoted individually | Pricing on request |
| Group onboarding | Practice-level setup: Tax ID / Type 2 NPI linkage, group payer records, roster build | $500 one-time |
| Ongoing maintenance | CAQH re-attestations, expirables tracking (license, DEA, malpractice, board), revalidations, payer roster upkeep with roster reviews for groups | $100 / provider / quarter |
| Contract rate negotiation | Full fee-schedule analysis & review of your top codes against Medicare benchmarks, then negotiation for stronger rates, fee due only on a successfully negotiated contract. Break-even math on your own volumes: pecs.health/roi | $500 / contract |
| Tax ID (EIN) procurement | IRS SS-4 prepared and filed; EIN delivered, for newly forming practices | $150 |
| NPI procurement | Type 1 (individual) or Type 2 (organization) NPI application prepared and filed via NPPES with the taxonomy set correctly, the field every payer cross-checks later. Registry-verified on delivery | $100 / NPI |
| Fingerprinting coordination | When an enrollment requires fingerprints (some Medicaid and state programs): we identify the requirement and the correct service code, book the IdentoGO Live Scan appointment near you, and track results through to the agency (IdentoGO's own collection fee is paid at the appointment) | $75 / occurrence |
| DME supplier Medicare enrollment | For accredited suppliers: Medicare DMEPOS enrollment (CMS-855S) with the National Provider Enrollment contractor, including fingerprint coordination for owners, site-visit readiness and development requests, followed through to approval. CMS's application fee, the surety bond and accreditation are paid by the supplier. DME supplier intake | $1,000 / location (half at engagement, half at approval) |
| DME revalidation or added location | Medicare DMEPOS revalidation (due every three years) or adding a practice location to an existing enrollment | $500 / location |
| DME Medicaid and commercial contracting | State Medicaid DME enrollment and commercial DME plan applications, at the standard prices: Medicaid $500 per state, each plan $200 | Standard prices |
| Becoming a DME supplier | Standing up a new DMEPOS supplier: accrediting-organization selection and application support, surety bond and supplier-standard readiness, facility and licensure requirements, then enrollment. A longer engagement with real prerequisites and lead times, quoted after we review your situation together | Pricing on request |
| Therapy practices: PT, OT and speech-language | Payer enrollment for physical, occupational and speech-language therapists and their groups: Medicare (CMS-855I / 855B via PECOS), state Medicaid and its managed-care plans, CAQH, and commercial panels , including the therapy networks some plans delegate to Optum Physical Health and American Specialty Health, which need their own applications and run on their own clocks. The work tracks the standard package closely, so quotes are built from it; delegated-network applications are quoted per payer | Pricing on request |
| Special services | Not everything we can help with fits a list. Describe what you need and you get a straight answer on whether it's something we do and what it would cost, and if it isn't, a referral to someone who does | Pricing on request |
Pricing questions
How does half at engagement, half at approval work?
For each enrollment service the first half is invoiced when we begin the work and the second half only when the payer approves the application.
What if a plan's panel is closed or it declines my application?
If a plan tells us its panel is closed to your specialty or area, you get back what you paid for that plan, or you can have it credited toward another service. If a plan declines because of something in your own file, such as a license issue, a sanction or information that cannot be verified, the first half covers the work already done and the second half is never billed.
Do you take a percentage of collections?
No. Every service has a flat price per provider or per application, published on this page, and there are no long contracts.
Is there a bundle or package price?
No. Each enrollment is its own line so you pay only for the payers you actually want. A quote lists each line before you commit.
What does maintenance include?
CAQH re-attestation every 120 days (so you never pay the separate CAQH update fee while on maintenance), tracking of license, DEA, malpractice and board expirations, Medicare and Medicaid revalidations, and payer roster upkeep, billed per provider per quarter.