Physicians & Medical Practices
Credentialing For Physicians & Outpatient Medical Practices
We enroll physicians and outpatient practices with commercial payers, Medicare and Medicaid nationwide, and we document every application, follow-up and payer response along the way.
Updated October 25, 2026
Choose Your Situation
Choose The Credentialing Path That Matches Your Practice
Pick the sentence closest to your situation. Credentialing adds up every provider and payer you choose, so you see the total before checkout.
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Select One Situation.
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Recommended Package
Insurance Credentialing (New Provider)
Prepare and manage credentialing for the selected commercial payers under the clinic’s existing signed contracts.
Pricing$1,550 total for one provider and two existing payer relationships. Includes $750 setup and $800 for two applications. Additional payers are $400 each; two payer minimum
What We Handle And What Has To Be In Place
We handle: Application preparation, roster or affiliation work, payer follow-up, and status tracking for each selected provider.
What has to be in place: The clinic must already hold executed group contracts with every selected payer. The provider completes and attests their own DataSpring provider profile (formerly CAQH). If the provider would rather we update the profile, they can choose to share their sign-in through secure onboarding and change the password when we’re done.
Recommended Package
Insurance Credentialing (Group Credentialing And Contracting)
Build the selected new commercial payer relationships for the formed practice and each selected rendering provider.
Pricing$2,000 total for one provider and two commercial payer contracts. Includes $1,000 setup and $1,000 for two applications. Additional payers are $500 each; two payer minimum
What We Handle And What Has To Be In Place
We handle: Organizational contracting, credentialing and linking each rendering provider, portals, EFT/ERA, directory verification, managed follow-up, and status tracking.
What has to be in place: For a group or practice with its own Tax ID and Type 2 NPI that holds no contract with the payer yet. Payer participation, timing, effective dates, and approval remain outside our control.
Ongoing Or Complex Work
Need Software Or A Broader Transition?
Group Practice Moving Off Headway Or Alma
Group Credentialing And Contracting
$2,000 total for one provider and two commercial payers, setup includedStill deciding? Ask Practice Concierge to recommend one package and tell you why.
Relevant Experience
Grounded In Real Medical-Practice Operations.
Our physician work comes out of Ryan Berg’s experience with hospital professional billing at OHSU, nationwide outpatient practice support at Clinicient, multi-provider physiatry revenue cycle at Rehabilitation Medicine Associates, and finance leadership during Timber Dental’s growth from two to six clinics.
Behavioral health is still our deepest specialty. For physicians and outpatient practices, we stick to the work our experience backs up. That’s credentialing and payer enrollment, professional billing and A/R, and the reports and day-to-day operations an owner runs the practice on. If you need specialty coding expertise outside that, we’ll tell you before we start.
Meet our founder, review our medical billing services for physicians, or see our Portland and Oregon practice support.
By Specialty
What We Check First, Specialty By Specialty
The enrollment mechanics barely change from one specialty to the next. It’s the same payers, the same portals and the same CAQH/DataSpring profile. What changes is which records have to line up before the first claim goes out, so here’s where we start for each one.
Physiatry And Outpatient Rehabilitation
Physiatry groups bill clinic visits, procedures and hospital consults, and outpatient rehab practices bill therapy visits under limits and authorization rules that differ by plan. This is where our experience outside behavioral health runs deepest.
- Group, provider and location records matched across every payer
- Hospital and facility affiliations documented accurately
- Physician and therapist enrollments kept separate where payers require it
- Aged and written off balances reviewed, not assumed lost
Psychiatry, PMHNP And Therapy
Our deepest specialty. See psychiatry billing, PMHNP services and individual provider credentialing.
Cardiology
Cardiology carries Medicare volume, hospital affiliations, diagnostic services and procedure heavy revenue. The credentialing file has to match the people, locations and entities that deliver the care.
- Medicare and commercial payer work separated and tracked
- Hospital and facility affiliations documented accurately
- Diagnostic and procedure locations matched to the right entity
- Group, provider, portal, EFT and ERA records kept consistent
Dermatology
Dermatology mixes medical visits, procedures, pathology relationships and cash-pay cosmetic work. The file should describe the medical practice accurately without blurring in services payers don’t cover.
- Medical and cosmetic service lines described accurately
- Specialty, taxonomy, procedure and location records aligned
- Group and provider enrollments tied to the correct billing entity
- Insurance portals and payment enrollment ready for medical claims
Internal Medicine
Internal medicine often combines commercial panels, Medicare heavy volume, hospital relationships and several care locations. Those facts have to agree across provider, group and payer records, or the first claims find the gap.
- Medicare and commercial enrollments kept clearly separated
- Hospital, facility and group affiliations documented accurately
- Multi-location rosters and service addresses kept consistent
- EFT, ERA, portal and billing setup aligned to the correct entity
OB-GYN
OB-GYN care can span months, locations, facilities and payer changes. Effective dates and affiliations need to be right before a global maternity episode starts, not after.
- Commercial and Medicaid enrollment work separated clearly
- Hospital and delivery site affiliations documented
- Group, location, taxonomy and roster data aligned
- Each payer’s effective date confirmed before a global maternity episode starts
Orthopedics
Orthopedic revenue runs through office visits, imaging, therapy, surgery and facility relationships. We keep each provider’s own enrollment separate from facility and ancillary enrollment, because those are different applications.
- Professional, facility and ancillary enrollment needs separated
- Surgical and hospital affiliations documented accurately
- Specialty, taxonomy, group and location records aligned
- Payer and payment setup ready before high-value episodes are scheduled
Pediatrics
Pediatric practices depend on accurate provider, age range, location, Medicaid or CHIP, and vaccine related records. One small enrollment mismatch can disrupt a high-volume schedule.
- Commercial payer work separated from Medicaid and CHIP enrollment
- Provider age range and specialty data aligned across applications
- Group and location rosters kept current
- Payment enrollment, portal access and billing setup finished before you book that payer’s patients
Primary Care And Family Medicine
Primary care needs broad commercial participation. That means the right PCP designation at every payer, location records and rosters that match, and payment enrollment that’s finished, all without eating into margins that are already thin.
- PCP designation and provider directory accuracy
- Group, location and roster consistency across broad payer panels
- EFT, ERA, clearinghouse and billing readiness alignment
- Preventive service and primary care taxonomy details that affect enrollment
Urgent Care
Urgent care is unusually sensitive to locations, hours, rosters and the line between professional and facility work. Every operating site has to be represented correctly before it’s marketed as in network.
- Every service location matched to the correct entity and group
- Professional and facility requirements identified before purchase
- Provider rosters kept current as staffing changes
- Portal, EFT, ERA and billing setup aligned before the site is marketed as in network
Beyond A Fixed Package
Complex Work Receives A Written Scope And Price First.
Old unpaid claims, facilities, ownership changes, more than one business and broader operations don’t fit a fixed package, because the price depends on what’s already in motion. We look at your situation before quoting, then put the included work, boundaries, price and start conditions in writing before you commit.
Questions We Get
Physician Credentialing Questions
How Much Does Physician Credentialing Cost?
It depends on where you are starting. Changing your practice’s Tax ID with payers you already participate with is quoted in writing. Adding one provider to two contracts your clinic already holds is $1,550 total, including $750 setup and $800 for both applications. Getting two contracts under your practice for one provider is $2,000 total, including $1,000 setup and $1,000 for both applications. Additional payers are $400 or $500 each for the matching situation. Both have a two payer minimum. Medicare or Medicaid enrollment is $450 each with no setup fee, on its own (two enrollments) or with a package.
How Long Does Physician Credentialing Take?
Plan on 60 to 120 days per payer. That range is set by the payers and the state, not by us. Some move quickly and some sit. We file complete applications, track each one, and tell you where every payer stands instead of leaving you to guess. Nobody can promise you an approval date.
Do You Credential Psychiatrists And Other MD And DO Providers?
Yes. Our deepest experience is psychiatry, PMHNP, and behavioral health, and that work carries straight into physician credentialing and outpatient medical practices. Same payers, same portals, same enrollment mechanics.
Can You Move My Payer Contracts To A New Practice Or Tax ID?
Yes, as long as you are already credentialed. We quote that work in writing, so ask for a quote. Payer contracts are tied to the credentialed business and Tax ID, so they do not follow you automatically when you form a new one.
Who Completes The CAQH/DataSpring Attestation?
You do. We are added as your authorized practice manager and we keep your CAQH practice data, locations, identifiers, and re-attestation dates current while we work your applications. After that, Ongoing Credentialing keeps it current. You complete and attest your own profile. If you’d rather we update your profile for you, you can choose to share your sign-in through secure onboarding and change the password when we’re done.
When Does The Work Start?
In-scope work begins within three business days after onboarding is complete. The clock starts when your completed information and required documents are received, not on the day you sign.
Do You Work With Specialties Outside Behavioral Health?
Yes. We’ve worked with physiatry groups, outpatient rehab practices, hospital professional billing and multi site dental groups, and our deepest work is with psychiatry, PMHNP and therapy practices. Credentialing and contracting, medical billing, operations and automation work the same way in each specialty. If a specialty needs coding expertise we don’t have, we tell you before we start.
Every price above is published on the packages and pricing page. If your situation doesn’t fit one of them, we’ll scope it and put the price in writing before any work starts.
Comparing quotes? We broke the whole market down here: what physician credentialing services cost.
See Services And Prices
Most of our services have published prices. Larger or more complex setups and ongoing partnerships get a written scope and price before they start.