Pricing

Medical Credentialing Pricing

Credentialing pricing based on your actual scope - not a one-size-fits-all package. Your cost depends on provider count, payer count, CAQH status, Medicare/Medicaid needs, and whether you need one-time setup or ongoing maintenance.

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At a Glance

Credentialing Pricing Ranges

Planning estimates. Final pricing depends on scope, complexity, and document readiness.

Service

Best For

Range

Free Audit

Unknown gaps or delays

Provider Setup

New or joining providers

$350-$750 / provider

Payer Enrollment

Medicare, Medicaid, commercial

$150-$450 / payer

CAQH Setup & Maintenance

Setup, cleanup, attestation

$250-$500 setup

Medicare PECOS

Enrollment or revalidation

$400-$900 / app

Medicaid Enrollment

State Medicaid programs

$400-$950 / state

Audit & Cleanup

Old files, unclear status

$500-$1,500 flat

Monthly Maintenance

Ongoing monitoring

$99-$249 / mo

Group Practice Plan

Multi-provider, multi-payer

Custom quote

Packages

Detailed Pricing Packages

Free Credentialing Audit

For practices that know something is delayed, missing, or unclear.

Includes

Initial call & issue triage

Missing item review

Gap discussion & next steps

Excludes

Full document review

Payer submissions

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Provider Setup

$350-$750

Per provider. New providers or providers joining a practice.

Includes

Document checklist & profile review

CAQH & NPI readiness check

Tracker setup & missing items

Excludes

Payer/licensing/malpractice fees

Full enrollment (separate scope)

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Payer Enrollment

$150-$450

Per payer. Commercial, Medicare, or Medicaid enrollment support.

Includes

Application prep & coordination

Follow-up log & status reporting

Excludes

Approval guarantee

Contract negotiation

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CAQH Setup & Maintenance

$250-$500

Setup fee. Optional: $50-$100/provider/month for maintenance.

Includes

Setup, cleanup, attestation

Document uploads & payer auth

Ongoing maintenance option

Excludes

License/malpractice renewal fees

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Medicare PECOS

$400-$900

Per application. Enrollment, updates, or revalidation.

Includes

PECOS application & data review

Revalidation tracking

Excludes

CMS approval guarantee

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Audit & Cleanup

$500-$1,500

Flat project fee. Old files, unclear status, messy records.

Includes

File review & missing doc list

CAQH, NPI, PECOS gap review

Cleanup plan & next steps

Excludes

Full payer submissions

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Monthly Maintenance

$99-$249/mo

Per provider/month. Ongoing monitoring and updates.

Includes

CAQH & license tracking

Revalidation monitoring

Roster updates & monthly reports

Excludes

New payer enrollment (separate)

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Group Practice Plan

Custom

Multi-provider tracker, roster support, weekly reporting.

Includes

Multi-provider onboarding

Payer map & roster support

Weekly status reporting

Excludes

Enterprise privileging

Request Custom Quote →

What Drives Cost

What Affects Credentialing Pricing

Provider Count

More providers means more document collection, profile review, payer mapping, and tracking.

Payer Count

One payer vs ten payers, Medicare, Medicaid, and state programs - each adds scope.

Provider Type

Physicians, NPs, BH providers, dentists, specialists may have different payer requirements.

CAQH Status

Clean and current vs missing, outdated, incomplete, or unauthenticated - different work levels.

Medicare / Medicaid

PECOS workflows and state Medicaid requirements add complexity and tracking.

Document Readiness

Missing malpractice, licenses, W-9, or NPI data increases cleanup work.

Follow-Up Complexity

Returned apps, closed panels, unclear status, and repeated requests increase tracking.

Maintenance Needs

One-time setup costs less than ongoing monthly monitoring and recurring updates.

Decision Guide

How to Choose the Right Option

Choose Free Audit If

Unsure what's wrong

Credentialing is stuck

CAQH may be outdated

Need a starting point

Choose Provider Setup If

Adding a new provider

Need files organized

Need CAQH/NPI checked

Preparing for enrollment

Choose Payer Enrollment If

Know your target payers

Need app prep & tracking

Need Medicare/Medicaid

Need follow-up visibility

Choose CAQH If

CAQH is outdated

Attestation expired

Docs need updating

Want monthly maintenance

Choose Maintenance If

Active providers enrolled

Recurring CAQH needs

Revalidation approaching

Rosters change often

Choose Group Plan If

Multiple providers

Multiple payers/locations

Adding regularly

Need weekly reporting

FAQ

Pricing Questions

Get Pricing Based on Your Actual Scope

A provider with a clean CAQH and one payer is different from a group practice with old files, revalidation risk, and Medicaid needs. Let's find the right fit.

Request Pricing →(512) 737-9877

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