Breaking Down Provider Credentialing Services Pricing

Sarah Jones

Using a provider credentialing service removes the stress and frustration associated with the process and often results in faster credentialing and enrollment. But, credentialing services pricing is a key factor in whether it fits your healthcare organization correctly.

Because of its complexity, credentialing costs can vary significantly depending on the services offered and the pricing model the credentialing services vendor uses. Keep reading for a complete breakdown of pricing for credentialing services and ensure your healthcare organization gets the value you expect.


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What To Look for in Credentialing Services

When evaluating credentialing services, it’s crucial to understand that not all vendors offer the same level of service. “Completing enrollments” can mean different things depending on the service provider. For some, this might mean merely submitting applications, while others include comprehensive payer follow-up and navigation through the enrollment decision process, such as approvals, rejections, and denials. Ask questions, thoroughly review the contract, and confidently decide.

Here’s a quick list of what to look for when selecting a credentialing services vendor:

  • State-specific expertise and experience
  • Network relationships
  • Visibility into the process through an online platform
  • Adherence to NCQA standards
  • Turnaround time that works for your organization
  • Flexibility and scalability
  • Accessible customer support and a dedicated point of contact
  • Comprehensive monthly reporting

Understanding Credentialing Services Pricing

There’s a wide range of credentialing services pricing, and it is usually one of two models: a la carte or all-inclusive. Understanding these models and their features can help you make the best decision for your organization.

A la Carte Pricing

With a la carte pricing, you pay for each service individually. While this initially seems to make sense — you’re only paying for what you need — it can lead to hidden costs and unforeseen expenses.

For example, if a credentialing service vendor does not clarify what is included, you may pay extra for critical steps like follow-ups or resolving application errors. Then you’re in a situation where you’re arguing over what should have been done and a provider’s enrollment is even more delayed than if you had done it yourself.

Here are some services that might be charged individually:

  • Application submission
  • Primary source verification
  • Payer follow-up
  • Background checks
  • License verification
  • Privileging

All-Inclusive Pricing

On the other hand, all-inclusive pricing covers a comprehensive range of services for a single fee. Even if there are parts of the coverage you think you might not need, this model is often more cost-effective in the long run. 

The greatest value comes from the seamless, end-to-end management of the credentialing process, which helps avoid costly delays and administrative burdens. Plus, this option is perfect for organizations that are growing or where staffing changes could cause major slowdowns.

All-inclusive pricing typically indicates a more comprehensive service, ensuring that every aspect of the credentialing process is handled professionally and efficiently. This transparency and reliability are invaluable for healthcare organizations focusing on the patient experience rather than administrative hassles.

Calculate the Value of Credentialing Services

Instead of focusing on credentialing services pricing, let’s think about the value. Delays in the credentialing process can be extremely costly. According to industry statistics, each day a provider cannot see patients due to credentialing delays, which can cost a healthcare organization approximately $9,000.

Let’s say you’re paying $5,000 per year for credentialing services for all of your providers. Even if you’re paying $10,000 per year – if one provider is credentialed just one day faster, you’ve more than paid for your investment. Imagine if 10 new providers are credentialed 2 days faster each. They’re able to make an additional $180,000 for your organization. That’s worth the $5,000-10,000 you paid for the services, right? And you didn’t have the headache.

MedTrainer Credentialing Services customers save, on average, three weeks per provider.

See how we do it in this 2-minute video.

Choose MedTrainer Managed Credentialing Services

MedTrainer Credentialing Service relies on our robust credentialing platform to provide complete visibility of the credentialing process. With MedTrainer’s Managed Credentialing Services, you benefit from:

  • Comprehensive Service: MedTrainer’s platform manages every step of the application submission process, from payer follow-up to recredentialing.
  • Transparency: Real-time updates and visibility into every part of the process ensure you are always informed.
  • Efficiency: MedTrainer streamlines the credentialing process, reducing delays and administrative burdens and allowing you to focus on patient care.

Schedule a demo today or talk to a MedTrainer Credentialing Services expert.