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.
Reviewed by Ryan Berg · Updated July 2026
Choose Your Situation
Choose The Credentialing Path That Matches Your Practice
Pick the sentence closest to your situation. First Practice Launch has one fixed price, and credentialing adds up every provider and payer you choose, so you see the total before checkout.
Start Here
Select One Situation.
Pick one and we'll show the package, the full price, what's included and where to buy.
Recommended Package
First Practice Launch
Build the business, payer, EHR, portal, scheduling, and billing foundation together.
Full Price$1,000 a month for six months, or $6,000 total
What We Handle And What Has To Be In Place
We handle: A 90-day guided build for providers starting from zero or with the practice formed but the business setup unfinished.
What has to be in place: For a licensed provider who is not already operating. If licensure is pending, the practice is already open, or the fit is uncertain, ask Practice Concierge first.
Recommended Package
New Provider Credentialing & Contracting
Prepare and manage credentialing for the selected commercial payers under the clinic’s existing signed contracts.
Pricing$550 per selected commercial payer, per provider
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 wants us to maintain the profile, they share access securely and change the password when we’re done.
Recommended Package
Move Existing Payer Relationships To A New Practice Or Tax ID
Move the selected existing commercial payer relationships to your new practice billing organization.
Pricing$450 per selected commercial payer, per provider
What We Handle And What Has To Be In Place
We handle: Payer transition work, group NPI and Tax ID updates, portal coordination, and EFT/ERA re-enrollment for each selected provider.
What has to be in place: The provider must already participate with each selected payer. Payer timing, effective dates, and approval are not guaranteed.
Recommended Package
Direct Payer Contracting & Credentialing
Build the selected new commercial payer relationships for the formed practice and each selected rendering provider.
Pricing$700 per selected commercial payer, per provider
What We Handle And What Has To Be In Place
We handle: Organizational contracting, rendering-provider credentialing and linking, portals, EFT/ERA, directory verification, managed follow-up, and status tracking.
What has to be in place: The practice must already have an EIN and Type 2 NPI. Payer participation, timing, effective dates, and approval remain outside our control.
Ongoing Or Complex Work
Need Software Or A Broader Transition?
Leave Headway, Alma Or A Group
Direct Payer Contracting
$700 per payer, per providerStill 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 the operator behind the work, 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.
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 actually 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.
Billing, aging A/R, denials, facilities, ownership changes, multiple entities 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. Moving payer relationships you already hold to a new practice or Tax ID is $2,250 per provider for up to five commercial payers. A first-time provider joining a clinic that already holds signed group contracts is $2,750 flat. A formed practice with its own EIN and Type 2 NPI going direct to payers is $4,000 flat. Additional commercial payers are $350 each. Medicare or Medicaid in any state is $450, added on top of a commercial 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. That is the Practice and Tax ID Transition, $2,250 per provider for up to five commercial payers. Payer contracts are tied to the credentialed entity 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. You complete and attest your own profile. If you want us to maintain your profile, you share access securely and change the password when we’re done.
When Does The Work Actually 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.
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 What It Would Cost Your Practice
Every service has a published price and a written scope. Not sure which one fits? Ask, and we’ll point you to the right one.