Physician Credentialing
What Physician Credentialing Services Cost
Physician credentialing runs roughly $150 to $500 per payer for admin only filing, or $2,500 to $5,000 per physician for a full-service company, often plus $100 to $250 a month for maintenance. Insurance Credentialing starts at $1,200 for two payers. Our totals are $1,550 to add a physician to two contracts the clinic already holds, or $2,000 for one physician and two contracts under the practice, with mandatory setup of $750 or $1,000 and two applications at $400 or $500 each. Two payer minimum.
Compare Credentialing PackagesFirst, Three Things People Mix Up
If you searched for physician credentialing cost, the results probably blended three different things that don’t cost the same.
Board certification is your specialty board. Exam fees, MOC and CME are handled with ABPN, ABIM or whichever board applies.
Hospital privileging is a facility granting you the right to admit and treat there, run by its medical staff office and usually free to you.
Payer credentialing and enrollment is getting an insurance company to accept you as a participating provider, so claims pay in network. This page prices that one, and it decides whether you can bill.
What The Market Charges
Per Payer, Admin Only: Roughly $150 To $500 Per Plan
You pay per application for someone to file the paperwork. Follow-up is often limited or billed separately, and it adds up fast: five commercial payers at $400 is $2,000, before Medicare or Medicaid. It works with a clean history if you’ll chase status yourself.
Full-Service, Managed: Roughly $2,500 To $5,000 Per Physician
A company owns the whole cycle for a physician going out with a full set of commercial payers. Most also charge maintenance, commonly $100 to $250 a month, covering CAQH/DataSpring re-attestation reminders, license renewals, and the three-year recredentialing cycle most payers run.
With either model, the published number is rarely final, so ask what happens if a payer closes its network, your application sits ninety days, or a name or address change forces a refile.
What AdvanceAPractice Charges
Our prices are published. The right one depends on where the payer relationship starts, which providers are included and the payer paths you pick.
Changing Your Tax ID, Quoted In Writing
You’re already credentialed and moving to a new practice or Tax ID. Payer contracts are tied to the credentialed practice and Tax ID, so they don’t follow you on their own when you incorporate. We quote that work in writing, so ask for a quote.
New Provider Credentialing, $750 Setup Plus $400 Per Payer
You’re joining a clinic that already holds a signed contract with each payer you pick. The total is $1,550 for one provider and two payers: $750 setup and $800 for both applications. Additional payers are $400 each, with a two payer minimum. We prepare the enrollment, roster, affiliation or linking work each payer needs.
Group Credentialing And Contracting, $1,000 Setup Plus $500 Per Payer
Your practice is formed, you have an EIN and a Type 2 NPI, and you need your own contracts, not a spot on somebody else’s. The total is $2,000 for one provider and two commercial payer contracts: $1,000 setup and $1,000 for both applications. Additional payers are $500 each, with a two payer minimum.
First Practice Launch, $1,500 A Month For Four Months, Or $6,000 Total
You’re opening your own practice for the first time, including after years on a platform. This isn’t a credentialing package. It covers the business setup and identifier work, five commercial payers followed to each payer’s written decision, portals and EFT and ERA, EHR selection and setup, and scheduling and billing configuration. 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. Both payment options share the same 90 day Launch period, work and handoff schedule, with every stage open right away. Monthly installments remain due as agreed after handoff; a payment not yet due does not delay work or handoff.
Add-ons are flat: every payer after the setup fee is one price, added one at a time up to 10 per provider. Medicare or Medicaid enrollment is $450 each with no setup fee, alone or with a package. Pay in full and your closeout package comes when the work is done, with no monthly autopay.
What Waiting Costs
Credentialing usually takes 60 to 120 days per payer. Payers and the state control that clock, not whoever you hire, and the bigger expense is usually months of a fully staffed schedule you can’t bill in network.
Run your numbers on the credentialing delay cost calculator before picking the cheapest option.
Common Questions
Does The Price Change By Specialty?
No. Package prices follow the payer work, not the specialty. Extra steps like hospital privileges or facility enrollment, and anything else outside a package, get a written price before we start.
How Long Does Physician Credentialing Take?
Plan on 60 to 120 days per payer. Some payers move quickly and some sit for months. We file complete applications, track each one, and tell you where every payer stands. Nobody can promise an approval date, so be skeptical of anyone who does.
Can I See Patients While I Wait?
You can see cash-pay patients, and some payers may let you bill retroactively to the effective date once approved. That varies by payer and contract, so we’ll tell you which of your payers allow it before you schedule around it.
What Makes Physician Credentialing Cost More Than A Nurse Practitioner?
Usually it doesn’t. The work follows your history, not your credential: multi-state licensure, gaps in work history, name changes, prior malpractice claims, and hospital affiliations all add applications and follow-up.
Who Completes The CAQH Attestation?
You do, completing and attesting your own profile. We’re added as your authorized practice manager and keep your CAQH practice data, locations, identifiers and re-attestation dates current during your applications. After that, Ongoing Credentialing does. If you’d rather we update it, you can share your sign-in through secure onboarding and change the password when we’re done.
Is Doing It Yourself Viable?
For one or two payers with a clean history, yes, though it’s tedious. It stops being viable at five payers across multiple portals, each with its own status process, while you’re also opening or running a practice.
When Does The Work Start?
In-scope work begins within three business days after onboarding is complete and we receive your completed information and required documents, not when you sign.
Where To Go Next
Every price above is on the packages and pricing page, where the builder shows your itemized total before asking for contact details. For the physician side, see physician credentialing services. State detail is in credentialing and payer enrollment by state.
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.