Insurance Credentialing Services: 10 Options Compared by Published Price (2026)
November 9, 2026
Insurance credentialing services are companies or specialists that enroll a healthcare provider with insurance payers: building the CAQH profile, filing each payer's application, following up until a participation date is confirmed, and keeping every enrollment current afterwards. As of 9 November 2026, published prices run from $80 to $270 per payer application, and from $1,400 to $1,750 per provider for a bundle of payers. Per-payer services (e.g., RevenueCTRL, MedSole, TheraThink, ClaimCarePro): $80 to $250 per commercial payer, and up to $270 for Medicare or Medicaid. Billing companies (e.g., Carepatron): credentialing included with managed billing for up to five payers per provider. Platforms (e.g., Medallion): custom quotes. Remote staffing agency, Latin America in US time zones (e.g., Virtustant): a dedicated credentialing specialist quoted per role, with zero placement fees, who handles new applications and the upkeep.
This guide compares 10 credentialing options by the prices they publish, shows how to count the applications and upkeep you are actually buying with the Application Ledger, and gives the start-date countdown that keeps a new provider from seeing patients out of network. Virtustant is a remote staffing agency and one of the options compared, so we stick to published facts and show every calculation. Third-party prices were read on each provider's own pages on 9 November 2026.
Credentialing is sold as one word, but it is four jobs, and quotes differ in which ones they include.
| Job | What it means | How often |
|---|---|---|
| CAQH profile | The provider's profile in CAQH ProView (now run by DataSpring), which most commercial payers read | Set up once; re-attested every 120 days |
| Payer enrollment | One application per payer per provider: Medicare (CMS-855), Medicaid, and each commercial plan | Once per payer, at hire or when adding a payer |
| Contracting | Securing the participation agreement and fee schedule, sometimes negotiating rates | Once per payer, revisited at renewal |
| Maintenance | Recredentialing, Medicare revalidation, and keeping licenses, DEA and malpractice documents current | Recredentialing every 3 years; Medicare revalidation every 5 |
A quote that covers submission only leaves follow-up, contracting and maintenance with you. Credentialing comes before billing: until a payer confirms the provider's effective date, claims to that payer go out of network or are denied. For the billing side, see medical billing services for small practices.
The short answer: published per-payer prices run from $80 (RevenueCTRL) and $99 (MedSole) to $250 (ClaimCarePro), and Medicare or Medicaid applications cost up to $270 each (TheraThink). For upkeep after approval, a dedicated credentialing specialist through a remote staffing agency (e.g., Virtustant, quoted per role, zero placement fees) handles CAQH re-attestation, recredentialing and payer follow-up as part of the job, instead of per event.
Ranked by the lowest published price per commercial payer application. Bundles, included services and quoted options come after.
| Provider | Published price | What the page says is included or required |
|---|---|---|
| RevenueCTRL | $80 per payer, including Medicare and Medicaid; 5 commercial payers credentialed free with its billing service | CAQH setup and re-attestation, Medicare and Medicaid, contracting, weekly status |
| MedSole RCM | From $99 per payer application, charged after the payer approves it; no monthly fee | Submission, weekly follow-up, CAQH setup and attestation, fee schedule review, Medicare, Medicaid and commercial payers |
| TheraThink | $160 per commercial insurance panel; $270 for Medicare and $270 for Medicaid | Inclusions not listed on the page |
| ClaimCarePro | $250 per payer per provider; CAQH setup $250; recredentialing or revalidation $250 per payer; maintenance $99 per provider a year | Follow-up until approval and written effective-date confirmation; payer and state fees passed through at cost |
| ClaimCarePro new-practice bundle | $1,750 for the first provider, $1,400 for each additional provider | CAQH, Medicare, Medicaid and 6 commercial payers |
| Carepatron | Credentialing included with its managed billing at 3.9% of collections, for up to five payers per provider | Guarantees commercial credentialing within 60 days, counting only its own days |
| Medwave | Priced per provider per insurance company; amount not published | Enrollment, CAQH setup, revalidation tracking, recredentialing, contracting; average turnaround 85 days from complete documents |
| Medallion | Custom quote | Credentialing and enrollment platform for provider groups |
| MedicalVirtual (staffing) | $8 to $12 an hour for a dedicated specialist, month to month | Applications, CAQH attestations, payer follow-up, revalidations; does not do primary-source verification or hospital privileging |
| Virtustant (remote staffing agency) | A dedicated credentialing specialist, quoted per role; zero placement fees | Month-to-month; lifetime replacement guarantee; works in your payer portals, CAQH and tracking tools |
Three pricing models sit in this table: per application (pay for each payer filed), bundled or included (a package per provider, or credentialing folded into a billing fee), and per hour (a person who does the work, including the upkeep). The right one depends on how many applications and maintenance events you have each year, which the next section counts.
Credentialing quotes are hard to compare until you count what you are buying. We call the count the Application Ledger:
Example: two new providers, each enrolled with Medicare, Medicaid and 6 commercial payers, with a CAQH profile each. That is 16 payer applications and 2 CAQH profiles, the same scope as ClaimCarePro's new-practice bundle.
| Pricing basis | Cost for 16 applications and 2 CAQH profiles |
|---|---|
| $80 per payer (RevenueCTRL, CAQH setup listed as included) | $1,280 |
| $99 per payer application (MedSole, CAQH setup listed as included) | $1,584 |
| $160 per commercial panel, $270 per Medicare or Medicaid (TheraThink) | $3,000 (12 × $160 + 4 × $270) |
| Bundle: $1,750 + $1,400 (ClaimCarePro) | $3,150 |
| À la carte: $250 per payer + $250 per CAQH setup (ClaimCarePro) | $4,500 |
The spread is wide, $1,280 to $4,500 for the same count, so read what each price includes before comparing. Two details move the real cost: when you are billed (MedSole bills after approval; ask others whether they bill at submission), and whether contracting and follow-up until a confirmed effective date are inside the price.
Approval is not the end. NCQA requires recredentialing every three years, CMS requires Medicare revalidation every five years (three for medical equipment suppliers), and CAQH profiles are re-attested every 120 days. For a group of 10 providers, each enrolled with 8 payers (80 enrollments), the yearly upkeep looks like this:
| Maintenance event | How the count is made | Events a year |
|---|---|---|
| Recredentialing | 80 enrollments ÷ 3 years | About 27 |
| CAQH re-attestation | 10 providers × 365 ÷ 120 days | About 30 |
| Medicare revalidation | 10 providers ÷ 5 years | 2 |
| Total | About 59, plus licenses, DEA and malpractice renewals |
Priced per event at ClaimCarePro's published rates, about 27 recredentialings at $250 plus $99 a year of maintenance per provider is about $7,657 a year, before any new provider. Add two new providers a year at its bundle price ($3,150) and the total is about $10,807 a year, or about $900 a month. That is the point to compare a per-event vendor with a part-time dedicated specialist, who also covers expiring documents, roster updates and payer calls that per-application pricing bills separately or leaves with you.
Work back from the day the provider starts seeing patients, not forward from today. Published processing times vary by payer and by vendor:
| Source | Published processing time |
|---|---|
| MedSole (by payer) | Medicare 30 to 45 days; Aetna 30 to 45; Cigna 40 to 60; UnitedHealthcare 40 to 60; BCBS 50 to 70; Medicaid about 90 |
| RevenueCTRL | Commercial credentialing commonly 60 to 120 days from a complete application |
| Medwave | Average 85 days from complete documents |
| Carepatron | 60-day guarantee for new commercial credentialing, counting only its own days |
| MedicalVirtual | 90 to 150 days to payer approval |
Rule of thumb from these figures: file complete applications at least 120 days before the start date, and 150 days for Medicaid or slow payers. For a provider starting on 1 April 2027, that means filing by 2 December 2026, or by 2 November 2026 for the slower payers. The clock starts at a complete application; a missing document restarts the wait.
A credentialing company's fee is for the work; government and state fees are usually passed through on top, as ClaimCarePro states.
We searched Virtustant's recruitment system on 9 November 2026 for positions titled credentialing or enrollment and found none, then read the three medical billing job posts on file (February and October 2026). All three asked for claims submission and follow-up on unpaid or denied claims; two asked for payment posting. None listed payer enrollment or CAQH upkeep.
The pattern: practices rarely put credentialing into a billing role by default, so it falls between the biller and the office manager. If you want one person to own both, write enrollment, CAQH re-attestation and recredentialing dates into the job description. Client names, rates, budgets and salaries from these records are not published.
The US Bureau of Labor Statistics does not publish a separate category for credentialing specialists; the closest, medical records specialists, had a median wage of $24.59 an hour in May 2025. With benefits at 30.0% of total compensation in private industry (BLS Employer Costs for Employee Compensation, June 2026), the loaded hour is about $35.13, or about $6,088 a month full-time, before recruiting.
How the rate works at Virtustant: if you pay your agent $10/hr, we give them $9 and keep the dollar in the middle. The rate is all-in, with zero placement fees and month-to-month terms; see Virtustant pricing.
| Your situation | Best fit | Why |
|---|---|---|
| One or two new providers, a handful of payers | A per-payer service (e.g., RevenueCTRL, MedSole, TheraThink) | $80 to $270 per application; you pay only for what you file |
| A new practice that needs Medicare, Medicaid and several commercial plans | A bundle (e.g., ClaimCarePro) | $1,750 for the first provider, $1,400 for each additional |
| You also want billing handled | A billing company that includes credentialing (e.g., Carepatron) | Included for up to five payers per provider with 3.9% managed billing |
| A large group with many providers and locations | A credentialing platform (e.g., Medallion) | Custom quote; built for provider groups |
| Ongoing hiring, many payers, recurring upkeep | A dedicated credentialing specialist through a remote staffing agency (e.g., Virtustant) | One person owns applications, CAQH, recredentialing dates and payer follow-up |
For the front-end insurance work around each visit, see insurance verification services; for broader admin help, see what a healthcare virtual assistant does.
Virtustant is a remote staffing agency that places vetted credentialing specialists and other remote professionals from Latin America with US practices, quoted per role. Each placement is one named person working the US hours you set, full-time or part-time, inside your payer portals, CAQH and tracking tools: filing applications, calling payers until effective dates are confirmed, re-attesting CAQH, and tracking every recredentialing and revalidation date. Virtustant accepts the top 1% of applicants: 100% apply, 22% clear the recruiter screen, 9% pass cognitive (IQ), skills and English testing, 3% reach a live interview, 1% are hired. You get a shortlist of 3 to 5 vetted candidates within 48 hours of your first call, and your hire can start in 72 hours. Terms are month-to-month, with zero placement fees and a lifetime replacement guarantee with no time cap. Business associate agreement terms are reviewed on the discovery call.
What it does not do: Virtustant does not sell per-application credentialing or a fixed-price package. It places the specialist who runs the work for your practice, under your accounts and your direction. See the credentialing specialist role and medical biller role.
As of 9 November 2026, published prices run from $80 to $250 per commercial payer application (RevenueCTRL, MedSole, TheraThink, ClaimCarePro) and up to $270 for Medicare or Medicaid (TheraThink). Bundles run $1,750 for a first provider and $1,400 for each additional (ClaimCarePro). A remote staffing agency such as Virtustant places a dedicated credentialing specialist, quoted per role, with zero placement fees.
For one provider with Medicare, Medicaid and 6 commercial payers plus a CAQH profile, published prices give about $640 at $80 per payer, $792 at $99, $1,500 at TheraThink's rates, $1,750 for ClaimCarePro's bundle, and $2,250 at ClaimCarePro's à la carte rates.
Published figures range from 30 to 45 days for Medicare and some commercial payers to about 90 days for Medicaid (MedSole), 60 to 120 days for commercial credentialing (RevenueCTRL) and up to 150 days (MedicalVirtual). File complete applications at least 120 days before the provider's start date.
Yes. CAQH ProView, now run by DataSpring, is free for clinicians. Profiles must be re-attested every 120 days.
Individual physicians and non-physician practitioners filing a CMS-855I pay no application fee. Institutional providers pay $750 for applications filed in calendar year 2026.
NCQA requires recredentialing every three years. CMS requires Medicare revalidation every five years, or every three for medical equipment suppliers.
It counts what a credentialing quote covers: providers times payers, plus a CAQH profile per provider, priced at each published rate, then adds yearly upkeep such as recredentialing every three years and CAQH re-attestation every 120 days.
You get a shortlist of 3 to 5 vetted candidates within 48 hours of your first call, and your hire can start in 72 hours, with zero placement fees and month-to-month terms.
Third-party prices. Read on each provider's own pages on 9 November 2026: RevenueCTRL credentialing cost (19 October 2026) and credentialing page, MedSole credentialing services and cost guide (21 October 2026), TheraThink credentialing services, ClaimCarePro credentialing cost (23 October 2026), Carepatron managed billing, Medwave pricing and home page, Medallion pricing and MedicalVirtual credentialing services. Processing times are the providers' own figures. Figures are reported as published; prices and terms change, so confirm them in writing.
Calculations. Applications: providers × payers. Upkeep: enrollments ÷ 3 for recredentialing; providers × 365 ÷ 120 for CAQH re-attestation; providers ÷ 5 for Medicare revalidation. Countdown: start date minus 120 or 150 days. Loaded US hour: median wage ÷ 0.70; full-time month: 173.3 hours.
Virtustant data. Positions in Virtustant's recruitment system searched for credentialing, enrollment and medical billing titles on 9 November 2026; three medical billing job posts read in full.
Public data. Federal Register: CY 2026 Medicare application fee; CMS revalidations; NCQA credentialing standards; DataSpring (CAQH) for clinicians; BLS OEWS, Medical Records Specialists (May 2025); BLS Employer Costs for Employee Compensation (June 2026).
