How Much Are You Wasting On Physician Credentialing?

POTENTIAL MONEY WASTED ON CREDENTIALING BY HANDLING IN-HOUSE

The credentialing process is important because it can have a serious financial impact if it is not done accurately and in a timely manner. When it is done successfully, it can bring in new patients and more revenue. However, physician credentialing can be tedious, troublesome, and costly for everyone.

Consider the cost: 

• Assuming a rate of $100 per hour, it costs approximately $20,000/year for credentialing work per physician. 

• Additional costs related to office staff involved in follow-up and other support work, taxes, and other costs would mean more money spent.

• Incorrect or incomplete applications would also mean additional costs.

• Other lost revenue (which adds up with the costs of credentialing) would include:

  • Time spent on credentialing services vs. time spent with patients

  • Resolving issues with applications & submissions

  • Overseeing credentialing work

Realistically, you’re spending WAY more than $20,000/year on physician credentialing. But how does this cost compare to outsourced physician credentialing services? Here’s a quick overview.

Keep in mind that the cost of credentialing services varies by:

• Current credentialing status

• Number of physicians you want to add

• How quickly you grow your practice

• Changes in insurance contracts and/or providers

• Other services you contract from your credentialing provider

In general and on average, expect to pay $2,000-$3,000/year for physician credentialing services.

Here’s a breakdown of the different pieces:

• INDIVIDUAL PHYSICIAN CREDENTIALING: The average cost is $100-200 per physician, though this varies across credentialing service providers. When it comes to re-credentialing, you can expect costs that are approximately the same. Most insurances and facilities require re-credentialing on a two-year cycle, although some payers or facilities may extend that by a year.

• CAQH DATABASE: CAQH Proview is one potential solution for online provider data collection. The initial setup can cost between $200-500. The database helps eliminate duplication during the collection of information to support the credentialing process. Management costs depend on your credentialing provider’s level of involvement and how often you need to make changes to the database. Typically, you can expect about $50-100/month for basic database management.

• INSURANCE PANEL APPLICATIONS: Per insurance panel, expect to pay around $100 for an application. In some cases, this could be doubled.

To Sum It Up

Outsourcing your credentialing process indeed requires up-front effort and costs, and it is also true that overall costs will vary by provider. However, even the cost of top-end credentialing services pales in comparison to managing it in-house for $20,000 (plus hidden fees). As a bonus, outsourcing frees your team up to do what it does best -- help patients.

Get an Estimate for Physician Credentialing Services

Assistance with the credentialing process can be cost-effective. Could you benefit from credentialing service but would like a more accurate cost estimate? Contact our 99MGMT Credentialing Team for more information

Fill out the form below to request a quote: