Group and Practice Credentialing
Picture this. Your group just hired two new providers, both start Monday, and the schedule is already filling up. Then someone asks the question that stops the room: are they credentialed with any of our payers yet? They are not. So the appointments happen, the care is real, and not a single claim pays until the credentialing clears. If you run a group, or you are standing up a brand new practice, this is the trap. The hiring moves fast. The paperwork does not, unless someone is driving it.
That is the part we drive for you. Our medical credentialing services handle group practice credentialing as a core service.
Group practice credentialing is the process of credentialing and enrolling multiple providers under one group entity, meaning a single Tax ID and a group NPI, so the group and every provider in it are in network with your payers and the practice can actually bill. We run that whole thing for groups, new practices, and busy multispecialty teams.
What group practice credentialing is, and how it differs from individual
Individual credentialing verifies one provider. Group credentialing does that for everyone on your roster and adds a layer on top: the group itself.
Here is the group layer in plain terms. Your practice has one Tax ID, or EIN, and a group NPI, which is an NPI Type 2 for the organization. Each provider keeps their own NPI Type 1. To get paid as a group, each provider has to be linked to the group and their billing reassigned to it. With Medicare, the group enrolls on the CMS-855B and each provider reassigns their benefits to the group on the CMS-855R, with both the group and the provider enrolled, or enrolling at the same time. Commercial payers and Medicaid have their own group enrollment and linking steps, but the idea holds. Verify the providers, enroll the group, connect the two.
Want the single provider version first? Our provider credentialing page covers that, and this page builds on it for the whole group.
How group credentialing works, step by step
When we run it for your group, it looks like this:
Most of these run in parallel across payers, not one at a time. Pairing this with payer enrollment is how a group gets contracted and billing without losing months.
New practices and onboarding new providers
This is where groups feel the pressure most, so let's be specific.
Opening a brand new practice? The order matters. Get the entity and Tax ID set, register the group NPI Type 2, then start payer enrollment. Skip a step and the whole file waits. We help you sequence it so the foundation is right before any application goes out.
Growing group, onboarding new hires? The work never really stops, and that is fine. We keep your roster live and add each new provider as they sign. Submissions go out in parallel, and we usually lead with Medicare and your top two or three commercial payers by patient volume, so the bulk of your billing comes online first. One honest note: a provider can only bill once their effective date lands with that payer. The earlier you send us a new hire, the sooner they pay.
Documents and roster you will need
A clean roster up front is the single biggest thing that keeps a group file moving. At the group level we need your Tax ID or EIN, the group NPI, a W-9, group malpractice or liability coverage, and your practice locations. For each provider on the roster:
What we handle for your group
This is the part that earns its keep. Here is the scope we own:
What you supply is simple: your roster, your documents, signatures where a form needs them, and the payers you want to join. We do the rest. See how this fits with our credentialing services, or send the details now.
specific proof points — groups credentialed, providers onboarded, average turnaround, years in business. phone
Keeping your group enrolled
Credentialing is not one and done, especially for a group whose roster keeps changing. Most payers recredential providers every two to three years. CAQH profiles need fresh attestation to stay current, and Medicare runs its own revalidation cycle. On top of that, providers join and leave, and each change has to be filed so the group stays clean and your claims keep paying. We track those dates and keep the roster current, right alongside the rest of your payer enrollment.