For Clinics Adding A Provider
New Provider Credentialing Under The Contracts Your Clinic Already Holds
Insurance Credentialing for a provider joining contracts your clinic already holds. AdvanceAPractice adds your new provider to those commercial payer contracts and follows every application until the payer decides in writing and, once approved, confirms the provider is loaded.
$1,550 total to add one provider to two existing payer relationships. $750 setup per provider plus $400 for each payer. Pay in full, or monthly at the same total.
Secure checkout by 
Pay by card, Apple Pay or US bank account. HIPAA compliant, with a signed BAA.
Build Your Credentialing Price
Choose the work and how many insurance companies each provider needs. See your total before you pay. Provider and payer details come next, in secure onboarding.
Not open yet, or still employed and starting your own practice? First Practice Launch sets up your payers, EHR, scheduling and medical billing together.
See your exact total and payment schedule before you pay.
The more providers, the lower the price: 2 to 4 providers save 10%, 5 to 9 save 15% and 10 to 50 save 20%. The discount comes off the whole subtotal automatically. For example, a clinic adding 10 providers to contracts it already holds pays $1,240 per provider for two payers instead of $1,550.
Your Credentialing Price
Total
What Is Included
Track progress and next steps in your Command Suite. Each payer decides approval and effective dates.
Subtotal
Discount For Multiple Providers
Checkout keeps this exact selection and total.
Is This For Me?
The Clinic Contracts Must Already Be In Place
This Fits When
- The provider isn’t yet in network with the selected payers under your clinic’s contracts.
- The provider is joining an existing clinic.
- The clinic already holds signed group contracts with every selected payer.
- You need one provider added to two or more commercial payer relationships.
Choose Another Path When
- The clinic isn’t contracted with the selected payers yet. That’s Group Credentialing And Contracting, $1,000 setup plus $500 per payer.
- The provider is opening a new practice rather than joining an existing clinic.
- Your practice is changing its Tax ID and the provider already participates. We quote that in writing.
- The work includes outpatient facilities, ownership changes or more than one business.
Not open yet, or still employed and starting your own practice? First Practice Launch sets up your payers, EHR, scheduling and medical billing together.
Included Scope
What New Provider Credentialing Covers
Application Build And Submission
We prepare each payer specific application and enrollment packet for one provider across your selected commercial payers, submit them, and confirm each payer received and logged it. You provide the requested records, complete your own CAQH attestation and sign the forms that require your signature. We prepare, submit and follow the enrollment work. Some payers don’t use CAQH. For those, we complete their own application with you.
Insurance Portal Registration And Setup
We register the provider on the payer and clearinghouse portals the enrollments require: Availity, payer specific rosters, and EFT and ERA setup, so insurance payments reach the practice’s bank account and payment reports flow into your EHR. Once the payer approves the provider, we confirm the enrollment and payment connections included in your Order Form.
Roster And Affiliation Under Your Contract
We run the group roster add, the provider link, and the affiliation steps under the clinic’s existing contracts. Every payer handles this differently, so we work each one the way that payer requires.
We Run The Credentialing. You Sign Only What The Law Requires.
We run the whole process, start to finish. The only things that stay with the provider are what the law says they must sign or attest themselves, which means their own CAQH/DataSpring profile and the final payer applications. We prepare everything around those. 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.
Follow Up For A Written Payer Decision
Payers stall, lose files, and restart the clock. We follow up with every payer at least every 10 business days until it gives its decision in writing. If it approves the provider, we confirm the provider is loaded under your contract. We escalate when a payer goes quiet and resubmit anything that gets lost.
You can see where each payer stands in the Command Suite at any point. When a payer approves you, we tell you exactly how to bill it: which NPI and Tax ID, which billing provider, and when to switch. Or we set it up in your system for you.
Start with two payers. Each payer is $400 after the $750 setup fee, added one at a time up to 10 per provider. Medicare or Medicaid enrollment is $450 each with no setup fee. Every commercial payer you add still needs an executed clinic contract. Adding more than one provider? Group discounts apply automatically at checkout.
We can do the DataSpring/CAQH and payer portal work for you, or walk you through each step on a screen share if you’d rather keep the logins. It’s part of your package either way.
A Real Example
The Payer Confirmed The New Office. Then It Never Loaded The Contract.
A PMHNP practice was adding its second provider and a second office on its existing contracts, so five payer applications went in together for an October start. One payer confirmed the new office but never loaded the group contract, and the new provider’s claims sat unpaid. That’s the failure that eats months of a new provider’s revenue.
We took it to the payer’s behavioral health network contact, pulled the owner into the thread, held claims when the payer asked us to, and resubmitted once a participating effective date was set. By the following April, most of the backlog back to the provider’s start date had been reprocessed and paid.
Important Boundaries
What Is Not Included
- New group contracting for a clinic that does not already participate.
- A promise of payer panel availability, participation, processing time, effective date or approval.
- Credentialing an outpatient facility, adding a second business, changing who owns the practice, or anything else outside this package.
- Provider CAQH attestation. Only the provider can attest.
- Medical billing, claim form or coding work, which is Ongoing Billing or a separate quote. We still answer your questions about what each approval means for your billing.
The provider completes and legally attests their own DataSpring provider profile (formerly CAQH) and signs payer required applications. Payers control their own review and outcome.
Before You Buy
Check That Your License And Payers Fit
Check Your License With Each Payer
Which payers will credential you, and how, depends on your state, your license level, the payer and whether you’re supervised. An LSW and an LISW, for example, can be handled differently. We confirm every payer in each state before we apply, and we’ll tell you in writing if yours doesn’t fit.
Medicare And Medicaid Enrollment
Government enrollment covers new Medicare and Medicaid enrollments, and it doesn’t include billing. We don’t take on fixing an application that has already been denied. We don’t work with ABA agencies.
Several Locations, States Or Health Plans?
You can price up to 50 providers online. For multiple locations, several states or a long list of health plans, send us your provider count, locations, states and plans and we’ll reply with a written quote within one business day.
One Person Owns Your Credentialing File
One person coordinates the work with you, from the first decision to the last follow-up. Everything runs in writing in the Command Suite, with status as each payer moves and a short summary each month. Meetings are on request, up to two a month.
After Payment
Choose, Pay, Finish Onboarding And Track The Work
Before You Buy
Check that your clinic already has an executed contract with every commercial payer you plan to pick. If you can’t confirm that, checkout stops before it takes a payment.
- Pay online. Right after, we email you a link to sign your agreements in the Command Suite.
- Your onboarding packet follows once you sign, and you upload your license and documents one time.
- We start within three business days of getting your completed packet.
What You See
Each Payer Has Its Own Steps
FAQ
New Provider Credentialing Questions
Do You Come To Our Office?
Our packages are built for telehealth, in person and hybrid practices. All of our work is done virtually, inside your EHR, your payer portals and the Command Suite, so we never come on site.
Is The Price Really Flat?
Yes. New Provider Credentialing is a $750 setup fee per provider plus $400 for each eligible commercial payer, with a two payer minimum, so two payers is $1,550 and five is $2,750. Add-ons and any group discount show in the checkout total before you pay.
Do You Complete CAQH Attestation?
No. CAQH requires the provider to complete and attest their own profile. We get the supporting information ready, make sure it matches what we send each payer, and manage every submission and follow-up from there.
What If Our Clinic Needs Payer Contracts?
Then this isn’t your package. A clinic that needs its own payer contracts starts with Group Credentialing And Contracting, a $1,000 setup fee per provider plus $500 per payer, with a two payer minimum. Once those contracts are signed, adding providers under them is what this package does.
Does The Provider Have To Be New To Credentialing?
No. It fits any provider who isn’t yet in network with these payers under your clinic’s contracts, whether it’s their first credentialing or not.
When Does Work Begin?
Within three business days after we have your complete onboarding information and required documents. The clock starts once your onboarding is complete, and we tell you the day work starts.
How Do You Get What You Need To Start?
Through your onboarding packet in the Command Suite. Everything uploads once into your secure workspace, and you add us as a user in DataSpring/CAQH, Availity and your EHR so we can work in them.
What Happens When I Add A Provider Later?
Tell us who’s joining and which payers you want, and we quote it in writing, usually the same week.
Can I Pay Monthly?
Yes. Monthly plans are available, at the same total as paying in full, with no interest or fees. You see the exact schedule before you pay.
What If Something Goes Wrong?
If something we delivered doesn’t work the way we said it would, tell us within 30 days of delivery and we fix it at no cost. If we can’t fix it, or can’t deliver what you bought, we refund the part it affected.
Want To Read The Order Form First?
- Your agreements. Right after your payment is confirmed, you’ll get an email invitation to the AdvanceAPractice Command Suite, where you’ll review and sign your Order Form, service agreement and BAA. Bank payments may take several business days to confirm.
- Onboarding. Your onboarding packet follows right after you sign, and you upload your documents there. We begin work within three business days after we receive your completed onboarding information, documents and access.
- While we work. We review your CAQH and your documents with you, submit the applications in coordination with you and stay on each one until the payer puts its decision in writing. We follow up with each payer at least every 10 business days. If a payer says no or its panel is closed, you get that answer in writing and that payer is complete.
- On approval. You get the written effective date, confirmed portals and payment routing, so you know the day you can bill.
We’ll email you the Order Form for New Provider Credentialing with the exact scope, price and terms.
See Everything Included
Every Step
- We check what each payer needs and confirm your Type 1 NPI and NPPES record match.
- We build one credentialing file for each provider.
- We review your DataSpring/CAQH profile with you, tell you what to update and flag anything missing or wrong before anything is submitted. You complete and attest it, and we keep it in step with your applications while we’re working on them.
- Some payers don’t use CAQH. Where a payer wants its own or a paper application, we prepare and submit it, and the provider completes and signs it.
- We prepare and submit each application, or the roster addition when your clinic already has an agreement with that payer.
- We answer every request a payer sends for missing information.
- We follow up with every payer at least every 10 business days until the payer gives its decision in writing. We escalate when one stalls.
- Before you sign a payer contract, we explain how its rates and terms work and point out anything unusual.
- When a payer approves, we get the effective date and the provider number it assigns in writing.
- We confirm the payer loaded the provider, and we add or update the online directory listing. Approval alone doesn’t mean you can bill. You’re ready once the effective date, the directory listing, portal access and the claims connection are each in place.
- We register the payer portals and set up a portal user for the provider.
- When a payer approves you, we tell you exactly how to bill it: which NPI and Tax ID, which billing provider, and when to switch. Or we set it up in your system for you.
- We set up EFT and ERA with each payer, or guide you through it in your EHR if you’d rather do it yourself, or confirm them if your practice is already enrolled.
- You get a copy of everything we submit for you. Where a payer portal needs the provider to attest or submit, we prepare it and you do the final review and submission.
- A payer’s written denial or a closed panel completes that payer. Swapping in a different payer is a new payer at the per payer price.
- You get a closeout package with a re-credentialing calendar.
What You Provide
- Your onboarding packet and the documents it asks for.
- Your clinic’s legal business, EIN and Type 2 NPI already in place, and its signed contract with each payer you pick.
- Access where we need it. You add us as a user in DataSpring/CAQH, Availity and your EHR or practice management system, or we walk you through each step on a screen share.
- The provider completes and attests the CAQH profile and signs anything only the provider can sign.
- Any payer letter, email or call about this work, sent our way within two business days, and a heads up before you file anything with a payer yourself.
Timelines
- Right after you pay, you get an email invitation to the AdvanceAPractice Command Suite, where you review and sign your Order Form, service agreement and BAA.
- Your onboarding packet follows right after you sign your agreements, and everything uploads once into your secure workspace. If anything takes longer on your side, let us know and we’ll keep things moving as quickly as we can.
- We start within three business days of getting your completed packet back.
- Your payment choice does not delay application preparation, submission or payer follow up. Applications go out as soon as the required information is ready. Payments must stay current, and the closeout package follows the final payment.
- Credentialing approvals typically take 60 to 120 days, and each payer sets its own timing. We apply to every payer at once, so the slowest one sets the pace.
- We tell you about any payer decision or request within one business day of getting it, and we tell you as each payer goes live.
- You see where each payer stands in the Command Suite as it moves, plus a short monthly summary.
What’s Not Included
- Medicare and Medicaid, unless you add them at $450 each per provider. TRICARE and VA Community Care are quoted in writing.
- Appeals after a payer denies an application.
- Payers and providers beyond the ones on your Order Form.
- Ongoing medical billing, claims and coding, and EHR or clearinghouse support beyond setting up the provider. If a question falls outside this work, we tell you before we answer it.
- Negotiating rates on your behalf.
- Business formation and legal or tax advice.
- Anything only the provider can sign or attest.
- An EHR. We set the provider up in the one you already use.
- Getting new group contracts for a clinic that doesn’t have them yet. That’s Group Credentialing And Contracting.
Ongoing Support
- Questions are part of working with us, during setup and for as long as you’re a client. Send them in the Command Suite or by email, and we reply within one business day, usually the same day. If a question turns into new work, like a new build or a change to something we built, we send a written quote before we start.
- Up to two meetings a month if you need them.
- Your Command Suite workspace shows what we’re working on and anything we need from you. It stays fully open during the work, read only for 30 days after, and then it’s $99 a month if you want to keep it.
- If something we delivered doesn’t work the way we said it would, tell us within 30 days of delivery and we fix it at no cost.
- Everything we set up is yours. The accounts, the documents and what we build stay with your practice.
- After your applications are done, Ongoing Credentialing keeps every provider current. It’s a separate service. Complete is $100 per provider a month for up to three plans, plus $15 a month for each added plan, with re‑credentialing included. Essentials is $80 per provider a month and covers the same upkeep (CAQH re‑attestations, license, DEA and malpractice tracking, monthly exclusion checks, roster and location updates), with re‑credentialing billed when it comes due at $200 per provider per plan. Both start with a review of every provider with every plan in the first 30 days, and we quote it in writing.
Want This By Email?
We’ll send you everything above, with the PDF, so you can read it later or share it with your partner or CPA.
Choose The Right Credentialing Path
Opening a practice, adding a provider, moving existing payer relationships, and seeking new contracts require different work. See the price and scope that match your situation.