SERVICES PRICING
Straightforward pricing. No surprises. Only transparency.
Pricing that just makes sense.
Transparent, credit-based pricing. No hidden fees. No surprise billing. No upcharges. You know exactly what you’re paying and why.
How our service pricing works:
Every authorization is assigned a tier based on complexity. Each tier costs a set number of credits. You purchase credits upfront in a bundle or monthly retainer, depending on auth volume - use them as needed.
Tier 1 - Standard
1 Credit Per Auth
Bundle: $37.50
Retainer: $35.00
Tier 2 - Complex
2 Credits Per Auth
Bundle: $75.00
Retainer: $70.00
CHOOSE YOUR PLAN
PREPAID CREDIT BUNDLE
Best for smaller practices - No monthly commitment
10 Credits - $375.00 (~5-10 auths/mo)
20 Credits - $750.00 (~10-20 auths/mo)
*Credits valid for 90 days from purchase
*PPO alerts you at 20% balance remaining
*Work pauses at zero-no surprise charges
*Repurchase anytime at the same rate
Not sure which plan fits your practice? PPO provides a complimentary payer mix and authorization load assessment at onboarding to recommend the right starting package.
Tier 3 - Exceptional
3 Credits Per Auth
Bundle: $112.50
Retainer: $105.00
MONTHLY RETAINER
Best for consistent volume - $35.00/credit - save ~6.7% vs. bundles
40 Credits - $1400/mo (~20-40 auths/mo)
60 Credits - $2100/mo (~40-60 auths/mo)
80 Credits - $2800/mo (~60-80 auths/mo)
Custom - Assessed (Based on Volume)
*Up to 10 unused credits roll over each month (capped)
*Month-to-Month, no long-term contract
*Adjust credit level anytime with 30 day notice
*Overages billed at $37.50/credit on next invoice
*PPO alerts you at 20% balance remaining
Tier 1 Examples
Standard Medication Prior Auths, Basic Home Health, EPSDT Preventative Screenings, Standard PT/OT/ST, Continuation/Renewal Auths, CPAP/BIPAP Resupply, Routine DME Supplies
Tier 2 Examples
TRICARE - All Auth Types, Power Wheelchairs/CRT, AAC Devices, ABA Therapy, Home Ventilator/High-Acuity DME, Enteral Nutrition/Feeding Pump, Custom Orthotics & Prosthetics, First-Level Appeals, Expedited/Urgent Auths, Out-Of-Network Auths, Initial Auths of Complex Payers
Tier 3 Examples
TRICARE ECHO Program, 2nd-Level & Subsequent Appeals, Peer-To-Peer Review Prep, PPO-Drafted Letter of Medical Necessity, Multi-step or Multi-payer auths, etc.
PPO-Designated Exceptional Cases
Key Policy Highlights:
No Long-Term Contract - Month-to-Month for all plans. Adjust or cancel retainers with 30 days’ notice. Bundles have no recurring obligation.
Tier Escalation - If an auth escalates mid-process (e.g., denial - appeal), the additional work is a separate line item. Tier 3 always requires client approval before work begins. Some authorization types fall outside our standard Tier 1, 2, or 3 definitions due to payer-specific requirements, emerging service categories, or unique clinical circumstances. When Jennifer encounters an authorization that does not fit an existing tier, PPO will review the case, assess complexity, and propose a tier assignment with a written explanation before any work begins. No credits are deducted and no work is performed until the practice receives and approves the proposed tier in writing. Unclassified authorizations always require explicit client approval — there are no automatic charges.
Bundle Expiration - Prepaid bundle credits are valid for 90 days from purchase. Unused credits expire at 90 days - no rollover.
Overages (Retainer) - Credits used beyond your retainer are billed at $37.50/credit on the next invoice. You’re alerted at 80% utilization.
Retainer Rollover - Retainer clients may carry up to 10 unused credits into the following month. Rollover credits expire if not used that next month - they do not accumulate.
Payer Mix Assessment - New clients receive a complimentary intake review to determine the right starting plan and credit level. You can adjust your plan at any time.