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LET'S
APPLY FOR YOUR NEW STATE LICENSE IN TEXAS NOW
Financing is available to you. Simply complete the info below and you will be give the option when submitting payment
Engagement Form
Please Note: We will only need the basic information as mention below to get started. More info maybe requested throughout the course of this process.
Our Online Consulting Fees
Personal Assistance Service Agency ($10,000)
Home Health Agency ($10,000.00)
Hospice Agency ($10,000.00)
Your State Filing Fees
Corporation/LLC Filing Fee ($300) Due 10 Days after Inception
State Application Fee ($2625) Due 30 Days After Inception
Medicaid/Medicare Fee ($631) Due 90 Days After Inception
**A Doc Prep Rep will guide you on how & when to submit your State Filing Fees
Company Name
Has This Name Been Filed with the Secretary of the State?
Yes
No
Full Address
Phone
Email
What Type of License Are We Applying For?
*
Personal Assistance Services (PAS) -Only
Home Healthcare -Only
Hospice -Only
Home Health w/ PAS
Home Health w/ Hospice
Home Health, Hospice & PAS
How Many Owners will your business Have?
*
1
2
3
4
5 or More
What is the Full Name of the Principle Owner?
Name of Additional Owner
Name of Additional Owner
Name of Additional Owner
Name of Additional Owner
The services checked below are covered with this package. If the stated license you are applying for is not eligible for one of services listed please disregard this service as non-applicable.
*
Required
Obtain Incorporation/ LLC Certificate of Formation
Obtain Employer Identification Number (EIN)
Obtain National Provider Identifier (NPI)
Obtain A State License
Provide Policies & Procedure Manuals in a Downloadable Format
Provide a Medicaid Provider Number
Provide a Medicare Number (PAS Providers are not eligible for this service)
Provide Accredidation Consultation (PAS Providers are not eligible for this service)
Provide 4 Private Insurance Contracts (Carriers shall be selected base on location)
Provide 1 HHSC Contract for Primary Home Care
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