services Available & Pricing

On-Demand Webinars

Coming In The Future - Webinars! We will cover common topics of Insurance & Billing in Private Practice. Webinars will be offered on-demand for ease of fitting into your busy schedule and will have options for included Q&A/Consult time

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2025 Pricing Structure

INsurance Contracting/Credentialing

What is included:

A free initial consultation to discuss pertinent information about your practice and needs. Direction/Consultation on business establishment available outside of initial consultation at an additional fee. Medicaid and Medicare enrollment and reassignment for both billing entity and service only providers. Network contracting and Credentialing with chosen managed care organizations and products.

I limit the number of new credentialing inquiries I take at any given time to provide the needed amount of attention to completing tasks accurately, ethically, and in a timely manner. If you are interested in service please reach out for information as to whether or not new clients are being accepted at this time

PRICING:

$150 - NM Medicaid Group Practice Enrollment and Owner Affiliation/Enrollment

$150 - NM Medicaid BHA 432 Enrollment or Conversion from Group Practice (Must already have obtained specialty approval) *Pricing is entity only and transfer of existing affiliations - see below for new rostered provider pricing

$200 - Medicare enrollment for both individual and entity

$150 - Managed care organization (includes multiple product lines) applications for Group Practice and BHA (entity only).

$100 - MCO Roster Submission (BHA)

$100 - MCO Provider Add (Existing Group Practice)

$100 - Medicaid/Medicare Provider Add (Existing Group or BHA)


Full Service Billing

What is included:

A free initial consultation to discuss pertinent information about your practice and needs. I am available to contract as a 3rd party biller for your practice. As part of the service I will bill primary/secondary/tertiary claims, make claim corrections, and do follow-up on aging claims. Payment reconciliation is included. I will also assist with eligibility and benefits verifications as needed. Monthly reporting is available upon request.

PRicing:

$75 per hour plus tax

$30/month/provider charge for non EHR claims


COnsultations

About:

I am available for consultation as needed on a number of topics relating to practice management. With consultation you get to use my time however best works for you and to cover the specific topics you need help on. Some areas include

  • Business Organization Structure and Registration

  • Insurance Coverage 101 - Eligibility, Patient Responsibility, EOBs

  • Insurance Billing and Coding 101

  • Billing Do’s and Don’t - Network Regulations

  • Practice Management - Forms, EMR Setup, Clearinghouse Basics

  • Contracts and Credentialing

  • Practice Bookkeeping Basics

PRicing:

$70/hour + tax


Available Payers

You may be wondering which Managed Care Companies I am familiar setting up for practice Contracting/Credentialing. The following list are common payers I have successfully set up practices with:

  • Aetna

  • Allwell

  • Ambetter

  • Blue Cross/Blue Shield

  • Cigna

  • Molina

  • NM Medicaid (State/HSD Level)

  • Novitas/ Traditional Medicare

  • OptumHealth (Formerly United Behavioral Health)

  • Presbyterian Health Plan

  • Tricare

  • United Healthcare (GEHA, UMR, Shared Services, All Saver’s, & Oxford)

  • Western Sky Community Care

The following payers I have limited experience with but can assist with applying if interested:

  • ComPsych EAP

  • Humana

  • TriWest

  • Lyra

  • Workman’s Comp

Not seeing what you’re looking for? Just ask and I will research if this is an option

*As a general rule i do not offer Medicaid credentialing outside of NM or Medicare Credentialing outside the Novitas MAC