- Most new providers cannot bill commercial insurers in-network until credentialing is complete, a process that averages 90-120 days for commercial payers in 2026; the right partner starts before you see your first patient.
- A company that handles both billing and credentialing removes the handoff between billing and credentialing teams, the most common source of enrollment delays.
- Verimedix ranks #1 in our assessment for new practices because credentialing, payer enrollment, EFT/ERA setup, and billing sit with one accountable team rather than separate add-ons.
- Prioritize credentialing-timeline transparency, CAQH management, and Medicare/Medicaid PECOS enrollment support when evaluating vendors.
- Contract red flags for new practices: long lock-ins before you collect a dollar, large setup fees, and credentialing treated as an optional extra.
- Your clean claim rate in the first 90 days sets the financial foundation for the whole practice, so specialty expertise from day one is a revenue decision, not a preference.
Timing is the reason this pairing matters. Credentialing runs 60–150 days per payer; billing setup takes weeks. Run them sequentially with two separate vendors and a new practice can sit unable to bill for a full quarter after opening. The companies ranked below run both tracks in parallel under one accountable team — which is exactly what a new practice should be buying.
Why New Practices Need a Billing + Credentialing Partner, Not Two Vendors
When you open a practice, two operational tracks run simultaneously: getting credentialed with every payer you plan to participate with, and setting up billing so claims go out clean from day one. These tracks are tightly connected. If credentialing is incomplete, claims get denied. If billing is configured before credentialing finishes, payer IDs are missing and ERA/EFT enrollment has gaps. When two different vendors own these tracks, the handoff between them becomes the point of failure.
The most common revenue problem in a new practice's first six months is not clinical, it is billing to payers where credentialing is incomplete, producing denials and a backlog that takes months to unwind. The fix is one company that does both, with a defined timeline for each. See our insurance credentialing services and medical billing services for how the parallel setup works.
How We Ranked These Companies
We weighed the factors that actually determine whether a new practice reaches billing-ready status on time:
- Credentialing scope: CAQH setup, PECOS enrollment, commercial payer credentialing, and state Medicaid, or only some of these.
- Timeline transparency: a defined credentialing timeline and milestone tracking versus an opaque process.
- New-practice onboarding: a documented setup process rather than the same workflow used for established groups.
- Specialty billing expertise: demonstrable experience with your specialty's code sets and denial patterns.
- Billing performance: clean claim rate, denial rate, and days-in-A/R for comparable clients.
- Account management: a named contact accountable for both credentialing and billing.
- Contract terms: month-to-month or short-term options appropriate for new practices.
- EHR compatibility: whether the company works inside your existing EHR or PM system.
Top companies: quick comparison
| Rank | Company | Best fit | Credentialing depth | Contract fit for new practices |
|---|---|---|---|---|
| 1 | Verimedix | Solo & small independent practices | Full: CAQH, PECOS, commercial, Medicaid, ERA/EFT | Short-term, new-practice onboarding |
| 2 | Physicians Revenue Group (PRGMD) | Independent & specialty practices | Full-service billing incl. provider credentialing | Full-service billing engagement |
| 3 | Transcure | Practices needing billing + enrollment together | Strong: CAQH/PECOS & commercial payer enrollment | Flexible; advertises no onboarding fees |
| 4 | BellMedEx | Multi-specialty small practices | Enrollment/eligibility support within RCM | Pay-for-paid model |
| 5 | CureMD | Practices wanting an all-in-one platform | Credentialing offered alongside its EHR/billing | Platform + services |
| 6 | athenahealth (athenaCollector) | Technology-forward practices | Enterprise-grade enrollment within athenaOne | Platform-bundled |
| 7 | AdvancedMD | Practices standardizing on its software | Enrollment support with its RCM service | Software + optional RCM |
| 8 | CareCloud | Growing independents | Credentialing available within its RCM | Platform + services |
| 9 | Tebra (formerly Kareo) | Solo practices on its platform | Varies | Platform-bundled |
| 10 | AnnexMed | Larger groups & billing companies | Credentialing among its RCM services | Better suited to volume |
| 11 | GeBBS Healthcare Solutions | Health systems & large groups | Enterprise credentialing/enrollment | Enterprise-oriented, not solo |
#1 Verimedix: Best for New Practices
Verimedix is a full-service revenue cycle management partner built for small and independent practices, not a billing company that bolted credentialing onto its menu. For new practices, Verimedix runs a structured setup that moves billing and credentialing in parallel: CAQH profile creation and management, Medicare PECOS enrollment, commercial payer applications, ERA/EFT setup, NPI verification, and billing configuration all begin on day one, so claims go out correctly the moment approvals land.
Verimedix works with practices on a wide range of EHR and PM systems, including SimplePractice, Open Dental, Tebra, eClinicalWorks, Athenahealth, and DrChrono, and provides a dedicated account contact accountable for both credentialing milestones and billing performance. For solo providers and small groups who need one point of accountability from day one, it is the strongest option we evaluated for 2026.
#2–#6: PRGMD, Transcure, BellMedEx, CureMD, athenahealth
Physicians Revenue Group (PRGMD) is a full-service medical billing company (founded 1997) that handles RCM, denial management, and provider credentialing for independent and specialty practices — a people-led billing service rather than a software platform, which suits new practices that want a team to own enrollment and billing together.
Transcure pairs full-cycle billing with credentialing (CAQH, PECOS, and commercial payer enrollment) across 40+ specialties and works inside a practice’s existing EHR, making it a credible billing-plus-enrollment option for new behavioral, telehealth, and primary-care practices.
BellMedEx is a Seattle-based full-service billing company serving 75+ specialties on a pay-for-paid model, with enrollment and eligibility support included in its RCM scope — a fit for cost-sensitive new practices wanting billing and basic credentialing from one vendor.
CureMD is an all-in-one cloud EHR, practice-management, and billing platform for 30+ specialties that also offers credentialing services; best when a new practice wants clinical software and billing from a single technology vendor rather than a dedicated billing team.
athenahealth (athenaCollector) is primarily a cloud EHR/PM platform whose revenue-cycle services and payer enrollment run on a network-wide rules engine; enrollment is enterprise-grade but tied to adopting athenaOne, so it fits technology-forward practices more than those wanting a boutique credentialing team.
#7–#11: AdvancedMD, CareCloud, Tebra, AnnexMed, GeBBS
AdvancedMD is a cloud PM/EHR software company that offers payer-enrollment support with its optional managed-billing (RCM) service; strongest for practices that plan to standardize on its software. CareCloud is a publicly traded EHR/PM/RCM technology company whose credentialing sits within its RCM offering — a scalable platform rather than a hands-on small-practice shop. Tebra (formerly Kareo + PatientPop) bundles PM/EHR, billing, and marketing for practices up to about 10 providers, though credentialing depth varies and pricing has risen since the 2021 merger that formed Tebra. AnnexMed is a full-service RCM and coding outsourcing firm (20+ years) serving hospitals, groups, and other billing companies, with credentialing among its services but a volume orientation better suited to larger practices. GeBBS Healthcare Solutions is a large, KLAS-rated enterprise RCM/HIM outsourcer (14,000+ staff, PE-backed) built for health systems and large groups — powerful at scale, but not aimed at solo or new independent practices.
What a New Practice Needs in the First 90 Days
| Phase | Timeframe | Key actions |
|---|---|---|
| Foundation | Days 0-15 | NPI Type 1 & 2, CAQH profile creation and attestation, target payer list, Tax ID/EIN |
| Applications | Days 1-30 | Submit PECOS (CMS-855I/855B) and all commercial applications simultaneously |
| Follow-up | Days 30-90 | Proactive payer follow-up, respond to document requests within 48 hours, ERA/EFT enrollment as approvals land |
| Billing-ready | Days 90-120 | Confirm effective dates in writing, test claims, begin clean in-network billing |
Missing documents restart the clock on the affected verification, so proactive follow-up and complete files are what compress this timeline. For A/R and follow-up discipline once claims flow, see our revenue cycle management and denial management services.
Questions to Ask Before Hiring a Billing + Credentialing Company
- Exactly what is included in credentialing: CAQH, PECOS, commercial payers, state Medicaid, or only some?
- What is your typical timeline to fully credential a new solo provider with 5-8 commercial payers?
- How do you track milestones and communicate status to the practice?
- Who follows up with payers when applications are delayed or documents are requested?
- What happens if an application is rejected, do you handle resubmission?
- Is credentialing included in the billing fee, or billed separately?
- Can you provide a reference from a new practice in my specialty you set up from scratch?
- What is the contract length and the terms to exit early?
Frequently asked questions
Yes. Many billing companies provide credentialing, but depth varies: some handle CAQH setup and commercial credentialing comprehensively while others treat it as a basic add-on without dedicated credentialing staff. Confirm exactly which enrollment types are covered (CAQH, PECOS, commercial, Medicaid), the defined timeline, and who is accountable for follow-up when applications stall.
Commercial payer credentialing averages 90-120 days in 2026. Medicare via PECOS typically runs 60-90 days after a complete submission. Medicaid varies by state, roughly 45-75 days in automated states and 90+ days in manual-verification states. Total credentialing for a new solo practice commonly runs 90-150 days when applications are submitted simultaneously and followed up proactively.
Dedicated credentialing companies typically charge about $200-$800 per payer application, or a monthly management fee of roughly $500-$2,000 for ongoing credentialing and re-credentialing. Billing companies that bundle credentialing often include it in the collections-based billing fee or charge a one-time new-practice setup fee, which is frequently more cost-effective than using two separate vendors.
CAQH (Council for Affordable Quality Healthcare) ProView is a centralized database of provider credentialing information. Most major commercial payers, including UnitedHealthcare, Aetna, Cigna, Humana, and BCBS plans, use CAQH to verify credentials. A complete, attested, current CAQH profile is a prerequisite for commercial credentialing, and it must be re-attested every 120 days to stay active. Incomplete or outdated profiles are a leading cause of application delays.
In most cases, no, you cannot bill commercial payers in-network before credentialing is complete. Some payers offer provisional or retroactive periods under specific conditions (more common for Medicaid and group additions), but these vary by payer and state. Medicare allows claims only from the PECOS effective date, not earlier. The safest approach is to begin credentialing before opening and work with a partner that tracks payer-specific provisional rules for your state and specialty.
Credentialing is the payer's verification of a provider's qualifications, licensure, education, training, and history before granting in-network status. Payer enrollment is the administrative process of submitting the application, obtaining the contract, and setting the provider up in the payer's billing systems, including ERA and EFT. Credentialing must finish before enrollment is finalized. Confirm that a vendor's service covers both the verification and the enrollment/contract/ERA-EFT setup.