There is no single price for credentialing, because there is no single credentialing job. Enrolling one therapist with three commercial plans is a different amount of work from setting up a new multi-specialty group with Medicare, two Medicaid programs and a dozen commercial payers. This page explains what drives the price, so you can compare quotes on the same basis. For your own figure, the fastest route is a free credentialing check.
What decides the cost
| Factor | Why it matters |
|---|---|
| Number of providers | Each provider needs their own applications and their own profile |
| Number of payers | Each payer is a separate application with its own forms and follow-up |
| Payer type | Medicare, each state Medicaid program and each commercial plan run different processes; Medicaid managed care plans often each need their own enrollment |
| New group or existing group | A new group needs its own enrollment and contracts before any provider can be linked to it |
| State of the CAQH profile | A complete, attested profile saves work; a missing or out-of-date one adds it |
| Closed or narrow panels | Getting into a panel that is not accepting new providers can take appeals and extra correspondence |
| Ongoing upkeep | CAQH attestation, revalidation and re-credentialing continue for as long as the provider bills |
How credentialing services charge
Most services price in one of three ways:
- Per payer application. A set fee for each payer for each provider. Easy to compare, and the most common model.
- Per provider, per month. A monthly fee covering new applications and upkeep for each provider.
- Bundled with billing. Credentialing priced alongside a billing engagement, usually at a discount.
We quote per provider per payer, and discount it when you also use our billing services. Whatever model you compare, check what the price includes: CAQH setup and attestation, follow-up until an effective date, linking to the group, and revalidation later on.
Fees the payers charge
Most payers do not charge providers to enroll. The main exception is Medicare, which charges an application fee to institutional providers and certain suppliers, such as clinics enrolling as facilities and DME suppliers. Individual physicians and non-physician practitioners do not pay it. Some state Medicaid programs charge a similar fee to certain provider types. CAQH ProView is free for providers.
The cost of doing it yourself
Credentialing in house has no invoice, but it is not free. It takes staff hours on forms, portals and hold queues, and someone has to track every application and every attestation date. The bigger cost is time: each month a provider sees patients without an effective date is a month of claims that may never be paid. For most practices that delay costs far more than the credentialing itself.
Credentialing cost FAQs
Why do credentialing quotes vary so much?
Because they often cover different work. One quote may include only filing the application; another includes CAQH setup, weekly follow-up and revalidation. Compare what is included, not only the headline price.
Is re-credentialing charged separately?
It depends on the service. Ask whether revalidation, re-credentialing and CAQH attestation are included or billed when they come up.
How long does credentialing take?
With CureCloudMed the usual range is one to three months, counted from the day we have a complete file. See payer enrollment services for how each payer type works.
Get a quote for your practice
Tell us how many providers and which payers. We will send a price and a timeline.
Get a free credentialing check Talk to a credentialing specialist