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 50% at engagement and 50% at submission; CAQH (DataSpring) and Availity are billed 100% 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.
Updated October 2026. How long each enrollment typically takes, with legal deadlines, CMS targets and sources: credentialing timelines by state and payer. Which plans route behavioral health to a separate company: behavioral health carve-outs.
- Flat PricesNo percentage of collections
- Half Now, Half at SubmissionFor every enrollment application
- Closed Network?Your choice of a refund or a credit
- Live Status TrackingCheck any application by reference number
| Service | What you get | Price |
|---|---|---|
| CAQH (DataSpring) Profile, New Build | Created from your file: every section completed, documents uploaded, attested, with us added as an authorized user | $500 / provider (billed 100% at engagement) |
| CAQH (DataSpring) Profile, Update and Attestation | An existing profile completed and corrected, documents refreshed, attested | $250 / provider (billed 100% at engagement) |
| Medicare Enrollment | PECOS enrollment or reassignment (855I, 855R, 855B as applicable) and EFT setup, followed through to approval | $500 / provider (billed 50% at engagement, 50% at submission) |
| 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 (billed 50% at engagement, 50% at submission) |
| Availity Setup | Registration and payer-portal linkage on Availity, which most commercial plans route enrollment and status through | $250 / provider (billed 100% at engagement) |
| 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 (billed 50% at engagement, 50% at submission) |
| 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 (billed 100% at engagement) |
| Ongoing Maintenance | CAQH (DataSpring) re-attestations, expirables tracking (license, DEA, malpractice, board), revalidations, payer roster upkeep with roster reviews for groups | $100 / provider / quarter |
| Tax ID (EIN) Procurement | IRS SS-4 prepared and filed; EIN delivered, for newly forming practices | $150 (billed 100% at engagement) |
| 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 (billed 100% at engagement) |
| 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 | Quoted individually (billed 50% at engagement, 50% at submission) |
| DME Revalidation or Added Location | Medicare DMEPOS revalidation (due every three years) or adding a practice location to an existing enrollment | Quoted individually |
| DME Medicaid and Commercial Contracting | State Medicaid DME enrollment and commercial DME plan applications | Quoted individually |
| 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 (DataSpring), 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 |
| Behavioral Health and Psychiatry | Payer enrollment for counselors (LPC, LMHC), psychologists and neuropsychologists, LCSWs, LMFTs, behavior analysts (BCBA), psychiatrists and psychiatric nurse practitioners, and their groups: CAQH (DataSpring), Medicare where the license allows it (behavior analysts cannot enroll in Medicare), state Medicaid and its plans, and the behavioral networks many plans use instead of their medical network: Optum Behavioral Health (Provider Express) for UnitedHealthcare, Evernorth for Cigna, Carelon for some Anthem and Blue plans, and Magellan where a plan uses it. Each behavioral network application is priced like any other plan application | Same prices as every provider |
| Mobile and House-Call Enrollment | For providers who see patients at home, in assisted living or nursing facilities, or from a mobile unit: the home-visit area and each facility added to your Medicare, Medicaid and commercial enrollments, or new enrollments set up for a mobile practice | $200 / payer (billed 50% at engagement, 50% at submission) |
| 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 |
| 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. | $500 / contract |
Pricing Questions
How does billing 50% at engagement and 50% at submission work?
For each enrollment service the first 50% is invoiced when we begin the work and the remaining 50% when the application is submitted to the payer.
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 fee covers the work already done, and we tell you what the payer found and quote any reapplication.
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 (DataSpring) re-attestation every 120 days (so you never pay the separate CAQH (DataSpring) 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.