Pay Dues Browse membership dues and enrollment products. EPMN Dues Payment 1Product Selection2Membership Dues3Initial Credentialing Fees4Credentialing Reactivation or Expedited Service Fees5Recredentialing Fees6Other Services7Personal Information8Billing Information I'm interested in:(Required)Select all that apply. Membership Dues Initial Credentialing Fees Credentialing Reactivation or Expedited Service Fees Recredentialing Fees Other Services Membership DuesAnnual Membership Dues (for EPMN Membership) Quantity Price: $1,135.00 Quantity Dues are invoiced on a quarterly basis, at the rate of $225.00. Members may elect to pay the entire amount for Annual Dues as an alternative to making quarterly payments. Dues are assessed on a fiscal year basis, January 1 through December 31 for each calendar year. *Providers may elect to become EPMN Members in order to access exclusive programs and discounts negotiated by EPMN and available only to active Members (including exclusive discounts on Medical Malpractice coverage for qualified Providers). “Membership Only” participation in EPMN does not require the Member to be credentialed for Plan Participation, but makes the Member eligible for all other services and offered discounts. Late Payment is defined as payments not made within thirty (30) days of the defined due date on EPMN invoice to provider. Late Payments will be assessed a fee equal to ten percent (10%) of the defined Membership Dues invoiced to Provider.Subtotal Initial Credentialing FeesInitial Credentialing for Doctors/Physicians (MD, DO, DPM, OD, DC, DPT) Quantity Price: $545.00 Quantity Application fee includes two TINs per Member. Additional TINs are $350 each REMINDER: CREDENTIALING APPLICATION FEES ARE NON-REFUNDABLE, AND NO APPLICATION IS PROCESSED UNTIL THE APPLICATION FEE IS PAID.Initial Credentialing for All Non-Physician Providers (RN, NP, PA, CNM, CRNA) Quantity Price: $445.00 Quantity Allied Health (RN, NP, PA, CNM, CNA), Physical Therapists, Occupational Therapists, Licensed Professional Counselor, and Ph.Ds. Application Fees – Allied Health Professionals Application fee includes two TINs per Member. Additional TINs are $350 each REMINDER: CREDENTIALING APPLICATION FEES ARE NON-REFUNDABLE, AND NO APPLICATION IS PROCESSED UNTIL THE APPLICATION FEE IS PAID.Subtotal Credentialing Reactivation or Expedited Service FeesCredentialing Reactivation Fee Quantity Price: $210.00 Quantity Fee charged to reactive an application received by EPMN where staff began the process of getting the provider “board ready”. If an Application remains inaccurate or incomplete in any element (including payment for fees), after EPMN staff contacts the Provider (or Provider’s staff) about missing or incomplete Application information on three (3) separate occasions, the Application File will become inactive in the EPMN system. Initiating the Application process after a file is made inactive requires the payment of a File Reactivation Fee, as well as a second (2nd) Initial Credentialing Fee.Expedited Initial Credentialing Fee Quantity Price: $210.00 Quantity There is a 10-day window of opportunity for this service, beginning the Thursday before board to the Friday after board. Credentialing staff must approve this service on a case-by-case basis, taking into consideration workload and feasibility.Subtotal Recredentialing FeesExpedited Recredentialing Fee Quantity Price: $210.00 Quantity This is a fee that is assessed when Reappointment Applications are received past the deadline that is set forth in the correspondence that is sent out 3 months in advance. The purpose of the deadline is to ensure that the staff do not have to work the weekend before board meeting to get the documentation processed.Recredentialing Fee (all Providers) Quantity Price: $400.00 Quantity Recredentialing is required by the insurance plans every 3 years. EPMN Members will receive four (4) notifications of scheduled recredentialing, beginning one-hundred twenty (120) days in advance of the deadline for recredentialing to be complete. As a matter of compliance, any Provider’s failure to recredential in accordance with the triennial schedule results in the mandatory termination of the Provider’s Membership with EPMN and termination from all contracted plans.Subtotal Other ServicesPlan Participation Changes Quantity Price: $210.00 Quantity EPMN limits our members to a maximum of 2 plan changes per year per provider. (Fiscal Year January 1st – December 31st) If you need to change more than 2 times in a year’s period, not counting new solicitations (Messenger Notices) that are offered, there is a $200 charge to process those additional Plan Participation changes.Medicaid Application (Texas Only) Quantity Price: $520.00 Quantity EPMN staff will apply for number and forward that information to Medicaid in order for provider to get effective with the lines of business that were opted into on the Plan Participation Checklist. EPMN will be the “administrator” for Medicaid and will take care of the mandatory re-validation every 5 years. (Your office will also have administrator rights) This maintenance is included in this charge.Medicare Application/Enrollment Quantity Price: $520.00 Quantity EPMN staff will apply for number and forward that information to the payor in order for provider to get effective with the lines of business that were opted into on the Plan Participation Checklist. EPMN will be the “administrator” for Medicare and will take care of the mandatory re-validation every 5 years. (Your office will also have administrator rights) This maintenance is included in this charge.Group Medicare Application/Enrollment Quantity Price: $520.00 Quantity EPMN staff will apply for Group number which is required for the individual enrollment and forward that information to payors in order for provider to get effective with the lines of business that were opted into on the Plan Participation Checklist. EPMN will be the “administrator” for Medicare and Medicaid and will take care of the mandatory re-validation every 5 years. (Your office will also have administrator rights) This maintenance is included in this charge.Update Medicare Quantity Price: $200.00 Quantity Make any corrections to your existing Medicare accounts, i.e. change demographic information or add addresses.Update Medicaid (Texas Only) Quantity Price: $200.00 Quantity Make any corrections to your existing Medicaid accounts, i.e. change demographic information or add addresses.Group Medicaid Application/Enrollment (Texas Only) Quantity Price: $520.00 Quantity EPMN staff will apply for Group Medicaid number which is required for the individual enrollment and forward that information to payors in order for provider to get effective with the lines of business that were opted into on the Plan Participation Checklist.Medicare and Medicaid Application Bundle (Texas Only) Quantity Price: $775.00 Quantity EPMN staff will apply for number and forward that information to provider and also to the relative plans that were opted into on the Plan Participation Checklist. EPMN will be the “administrator” for Medicare and Medicaid and will take care of the mandatory re-validation every 5 years. (Your office will also have administrator rights) This maintenance is included in this charge. However, if there are any changes that have to be recorded, there will be a $125 charge for each change. If we are taking care of both Medicare and Medicaid, as a bundle, the charge for each change is $125 since we will have to update both.Update Medicare and Medicaid as a Bundle (Texas Only) Quantity Price: $350.00 Quantity If Medicare and Medicaid are being supported on a bundled basis and changes or corrections are required to both existing Medicare and Medicaid accounts, the fee will be $125 (i.e. change demographic information or add addresses).Group Medicare and Medicaid Application Bundle (Texas Only) Quantity Price: $775.00 Quantity EPMN will be the “administrator” for the GROUP Medicare and/or Medicaid and will take care of the mandatory revalidation every 5 years. (Your office will also have administrator rights) However, if there are any changes that have to be recorded, there will be a $75 charge for each change. If we are taking care of both Medicare and Medicaid, as a bundle, the charge for each change is $125 since we will have to update both.Add a Tax Identification Number (TIN) Quantity Price: $200.00 Quantity Explanation: This is a charge for a member to add a TIN at any time, once they are a EPMN member. This fee covers sending the information on the new TIN to the payors and getting effective dates for the new TIN.Direct Health Plan Contracting & Credentialing (for One Provider) Quantity Price: $730.00 Quantity Payment for EPMN to pursue a direct contract, with individual credentialing, for ONE Provider per contract. (For example, if 3 direct contracts were desired for a provider, then the quantity would be 3.)Direct Health Plan Contracting & Credentialing (for Additional Providers, beyond the Original One Provider) Quantity Price: $365.00 Quantity Payment for EPMN to pursue a direct contract, with individual credentialing, for ADDITIONAL Providers beyond the original one provider for each direct contract. (For example, if 4 providers in total need direct contracts with 3 health plans, the original One Provider would use the above $730.00 item, quantity 3, and the remaining 3 providers would use this $365.00 item, quantity 3.)Subtotal Name(Required) First Last Practice or Group Name(Required)Group/Individual NPI(Required)Invoice Reference #Email(Required) Phone(Required) Billing Address(Required) Street Address Address Line 2 City State ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Total Credit Card(Required) NameThis field is for validation purposes and should be left unchanged.
Mr. Website Designer