Medical Credentialing Services: Compare Companies, Prices, and What You Get

A medical credentialing service handles the paperwork a provider needs to apply to insurance plans. It can build your provider profile, file applications, and follow up with each plan. The plan still decides whether to approve you and when participation starts. You may also see parts of this work called provider credentialing, insurance credentialing, or payer enrollment.

For the billing side of an ABA practice, see the ABA billing services comparison.

We found seven companies that publish a service rate or starting price, including $79 per payer, $200 per plan per provider, and application volume tiers. Go Credentialing also posts monthly plans. Headway does the work for free through its platform. SimplePractice includes up to two applications with a paid software subscription.

The tables below show each price, what the company says it covers, and a link to the page where the company says it. Under the tables, type in your providers and plans to see how the posted rates multiply. Bundles, fee-counting rules, and the scope of your job can change your quote.

Prices and rules on this page were checked on October 5, 2026. The company links are unpaid source links.

On this page

• Companies and prices
• Calculate example costs
• Where to start, by situation
• What a credentialing service does
• Get quotes you can compare
• How long it takes
• Costs the fee doesn't cover
• Do it yourself, or ask your billing company?

Medical credentialing companies that post their prices

We looked for companies that post a dollar rate for their own credentialing service. We found seven. We also list four companies that need a written quote, including one with published cost guidance, and three routes without a separate credentialing service fee.

Companies are in A-to-Z order. This is not a ranking. We read each company's website. We did not hire these companies or test their work. A posted price tells you what a company advertises. It does not tell you how well the job gets done.

Priced per insurance plan or application

These are fees for enrollment work under the stated offer. They do not buy guaranteed acceptance. If a company counts one fee for each provider-plan pair, two providers joining six plans each is 12 billable units. Confirm that count before comparing quotes.

Three things to know before you compare these numbers:

1. The units are not the same. "Per payer," "per panel," "per network," and "per plan" can mean different things. A group practice may need one application for the practice and one for each provider at the same insurer. Ask how many fees your list really is.
2. "From" and "about" are not quotes. MedSole and One O Seven use starting prices. Veracity uses an approximate price. GetPaneled bundles and Go Credentialing volume tiers can change the arithmetic.
3. Upkeep is where prices split. CAQH-only upkeep at $9 a month is different from an annual management plan at $350 or $500. Fortify lists a $200-per-payer update rate; ask when a fresh fee applies. Wayfinder includes a year of some upkeep in its initial fee. Unknown is not zero.

GetPaneled’s terms say you may request a package-price refund if it cannot get you paneled within six months after it has the required information, documents, authorizations, and payer selections. This does not promise acceptance by every selected payer, and the refund does not cover outside costs or lost revenue.

Priced by the month

Go Credentialing’s terms say fees for work already submitted are not refundable just because a payer denies the application. Confirm the completion milestone, cancellation terms, and how you export your records.

Quote only

CureMD, Medallion, and Medwave did not post a dollar rate in the sources we reviewed. Practolytics publishes FAQ cost guidance without clearly defining a priced offer or the number of payers its packages cover. Get a written quote for any of these four.

A missing public price says nothing about quality. It does mean you need a written quote before you can compare.

Three routes with no separate credentialing fee, and the catch

Headway uses its own payer agreements and handles insurance billing through its platform. SimplePractice says you and your practice remain independently contracted with payers and responsible for claims and payments. Ask each plan what remains active if you leave; do not assume the two arrangements work the same way. (Headway, SimplePractice FAQs)

SimplePractice’s regular solo software plans are $49, $79, or $99 a month before introductory discounts. Its pricing also lists a $20 annual CPT code access fee per clinician, plus applicable taxes and add-ons. Once a credentialing request reaches Medallion intake, you cannot swap it to a different payer. Choose the payer before using an included application. (Software pricing, credentialing conditions)

Calculate credentialing cost examples

Enter your numbers. The calculator shows arithmetic using published service rates. It assumes every provider needs the same number of plans and each provider-plan pair is one billable unit. Enter upkeep providers and the managed roster separately. Bundles, discounts, extra applications, and a company’s unit rules can change the quote. The calculator itself does not save or send your entries.

Example: 2 providers joining 6 plans each. Assuming one billable unit per provider-plan pair, that is 2 × 6 = 12 units. Upkeep below separately uses two providers. The scopes are different; these are arithmetic examples, not comparable all-in quotes.

GetPaneled bundle example: for two eligible providers each seeking six payers in one state, two Full Panel bundles plus one extra payer each gives 2 × ($349 + $79) = $856. Its 10% group discount would make that $770.40. Confirm the package and eligibility in group checkout. The $948 calculator row deliberately shows the undiscounted single-payer arithmetic; it is not the cheapest package calculation. The group discount does not apply to optional CAQH upkeep. (Pricing, group checkout)

Example for the monthly plan: a roster of 3 providers. Applying Go Credentialing’s posted base fee plus a charge for all three providers gives $499 + (3 × $125) = $874 a month. Twelve months at that roster size and rate is $10,488. Confirm in writing that the per-provider fee applies to every rostered provider, and what work limits apply. This model covers ongoing roster work, so compare scope before comparing it with a one-time fee.

These totals leave out government fees and anything a company prices separately. The calculator keeps initial work and ongoing upkeep separate; it does not add them into a first-year total.

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Where to start, based on your situation

This is our read of the posted prices and scope. It is a starting point, not a ranking.

Compare billing options

What a medical credentialing service does, and what it can't do

People use "credentialing" for several related jobs. Companies bundle them differently. That is why two quotes for "credentialing" can be far apart.

What a service cannot do:

• It cannot override a plan’s decision about whom to admit. A company can ask about exceptions or reassessment of a closed panel.
• It can reduce avoidable delays by filing complete applications and following up.
• It cannot guarantee a payer’s approval or effective date. Get the payer’s confirmation. (UnitedHealthcare’s process)

Get quotes you can compare

Send every company the same request. Then you can line up the answers side by side.

Quotes differ most in three places:

• How fees are counted. One "plan" to you may be two or three fees to them.
• What happens after filing. Some fees stop at "submitted." Others include fixing problems, follow-up, and proof of your start date.
• Upkeep. Included for a year, billed yearly, or billed each time.

Ask for a written status for every plan throughout the job. Agree which outcomes close the engagement and which still require work:

1. Approved. You have written approval, the effective date, and any required signed contract or confirmation of addition to an existing agreement.
2. Denied or panel closed. You have the plan's reason and know the next step.
3. Waiting on the plan. You know the last update and the next follow-up date.
4. Waiting on you. You know which document or signature is missing.

A company can do its job well and still have a plan say no. That is why the request below asks what you owe in that case.

Your first email does not need patient information, Social Security numbers, or passwords. Send application documents later, through the secure method the company gives you.

How long does credentialing take, and when can you bill?

Timelines vary by payer and application. Ask when the clock starts and which milestone the estimate covers: filing, credentialing approval, or active participation.

Here is what one large insurer says. UnitedHealthcare says credentialing “generally takes up to 45 calendar days or more” once it has a completed application and all required information. Separately, it asks providers to allow up to 60 days for contract loading after credentialing is approved and a signed contract has been received. Confirm your effective date and completed onboarding before treating patients as an in-network provider. (UnitedHealthcare, Join our network)

Here is what the companies on this page say. These are their own statements, not promises.

When a company quotes the short end, ask what it is counting from and which plans it means.

The Medicare rule that makes your filing date matter

For physicians, non-physician practitioners, and the other provider types listed in 42 CFR 424.520(d), the effective date of Medicare billing privileges is the later of:

• The filing date of an enrollment application that the Medicare contractor subsequently approves.
• The date the provider first began providing services at the new practice location.

CMS explains that the filing date is when the Medicare contractor receives the application. (CMS enrollment guide)

For the provider types listed in 42 CFR 424.521(a)(2), retrospective billing may be available for up to 30 days before the effective date if all program requirements, including state licensure, were met; services were provided at the enrolled practice location; and circumstances prevented enrollment before those services were provided. A separate 90-day provision applies when a qualifying Presidentially declared disaster prevented advance enrollment.

So the filing date matters, but approval does not automatically make every earlier visit billable. Ask your Medicare contractor to confirm the effective date and any retrospective-billing period. Confirm commercial-plan and Medicare Advantage participation dates with those plans.

Put a week of delay in context

Use your own number here. Ours is only an example.

Suppose a provider is expected to generate $20,000 in monthly insurance collections. Using a 30-day month for illustration, seven days represents $20,000 × 7 ÷ 30 = $4,667 of expected collections, rounded to the nearest dollar. How much is delayed or lost depends on when services occur, effective dates, any retrospective-billing allowance, and claim payment.

Now compare the fee arithmetic. Using the $107 starting price strictly as an example, the gap from a $200 fee is $93. Across 12 billable units, that is $1,116. The actual quote and included work still matter.

Ask each company how many business days it takes to file after it has complete documents, and how it follows up on missing information. Use that commitment and the scope alongside price.

Costs the service fee doesn't cover

If a quote lists a $750 government application fee for an individual physician’s Medicare enrollment, ask the company to explain it. Its own service charge is separate. The applicable federal fee is $750 for 2026; $730 was the 2025 amount.

Upkeep to plan for after you are approved:

• Every 120 days: confirm your CAQH profile is still correct. This is called re-attesting. Illinois providers do it every 180 days. (DataSpring)
• At least every 3 years: Medicare Advantage organizations must recredential contracted physicians and other health care professionals, including members of physician groups. Check each payer’s requirements for your provider type. (42 CFR 422.204(b)(2))
• Generally every 5 years: Medicare providers and suppliers renew enrollment through revalidation; DMEPOS suppliers generally do so every 3 years. CMS can also request off-cycle revalidation. Check your actual due date in the Medicare Revalidation List. CMS posts dates seven months ahead and does not grant extensions. Missing the deadline can lead to payment holds or deactivation of billing privileges. (CMS, Revalidations)

Ask every company whether these three are in the price or a new bill later.

Should you do it yourself, buy software, or ask your billing company?

Doing it yourself

You can. The CAQH profile is free, and you can handle payer forms and required follow-up yourself. What you buy from a service is someone else’s time and responsibility for the agreed work.

It tends to work when you have one provider, a few plans, and someone organized who can check on each application every week or two.

For Medicare, CMS says applying online through PECOS is faster and easier than paper. You can authorize a helper through CMS’s Identity & Access system to work as a surrogate in the functions you approve. The helper uses their own authorized access; the required provider or organizational signer still signs the enrollment application. You can remove the helper’s access by disabling the connection. (CMS enrollment guide, I&A FAQ)

A middle path: build the free profile yourself, then pay per plan only for the applications you do not want to chase.

Paying a service

It tends to make sense when you have several providers or many plans at once, a new practice with no office staff yet, a stalled or rejected application, or providers in more than one state.

Buying software

Software helps your staff track documents, deadlines, and applications. Check who is responsible for answering the plan’s requests and fixing incomplete applications. If no one on your team owns that work, look for an offer that includes people to handle it. Some companies sell software and managed services together.

Asking your billing company

If you outsource billing, ask your billing company first. Several listed companies also sell billing, including Fortify RCM, MedSole RCM, One O Seven RCM, Practolytics, and Medwave.

One company for both means fewer handoffs when a new provider starts. The risk is getting tied in. Before you sign, check two things. Does the credentialing price hold if you buy it alone? Which accounts do you control, how can you remove the company’s access, and what application records and contracts can you take with you? A vendor’s own tracking portal may remain its system.

Still choosing a billing company? Our comparison shows posted fees, monthly minimums, and contract terms.

Compare billing options

Claims to question

• A promised approval date. The plan decides timing.
• Big percentages without enough detail to compare. Practolytics advertises a 98% first-pass approval rate, and CureMD advertises 90% faster onboarding. These are company claims, not independently measured results from us. Ask what was counted, over what period, against what baseline, and for which plans.
• A "top 10" list written by a company on the list. Check who wrote it, which alternatives it considered, and whether it gives evidence for the order.
• Full payment up front with no filing deadline.
• No clear answer on who keeps your logins.

Common questions

Does our group's contract cover a new provider automatically?

Do not count on it. UnitedHealthcare, for one, says a provider joining a practice that already has an agreement still has to finish its onboarding before seeing patients in network. (UnitedHealthcare) Ask each plan what it needs for a new hire.

Can a credentialing company get me into a closed panel or get me better rates?

No company controls a plan's network or its rates. A service can apply, ask about exceptions, and follow up. Some list rate negotiation as part of the fee. Fortify RCM and MedSole RCM do. Ask what the negotiation work includes; the payer decides the final terms.

If I switch companies, do my applications start over?

Not always. Ask your current company for the filing date, reference number, and latest status of every application. Give those to the new company and ask what it can pick up before it files anything twice.

Is credentialing the same as getting an NPI or a CAQH profile?

No. An NPI is your national provider identifier. A CAQH profile holds your details in one place. Neither one puts you in a plan’s network. You still need to complete each payer’s required enrollment or network-joining steps. (CMS NPI fact sheet)

How we checked this page

We opened each company's own pricing or service page on October 5, 2026 and wrote down the price as the company states it. We did not ask for quotes, hire any company, or measure results.

The rules come from the Code of Federal Regulations, the Federal Register, CMS, DataSpring, and UnitedHealthcare's provider site. Each is linked next to the fact it supports.

Being listed here is not a recommendation. Being left out is not a judgment. If a price or term has changed, tell us and send the source. Read more about how we research comparisons.

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Your next step

Pick two or three companies that fit your situation. Send each one the same quote request. Compare the answers on price, filing speed, upkeep, account control, and access to your records.

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Get the quote request

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