DIY vs. Credentialing Service: When to Outsource

Decision Guide

The Credentialing Choice

Every physician faces this question: handle credentialing yourself or pay someone to do it? The answer isn't universal—it depends on your situation, complexity, time availability, and how much you value your non-clinical hours.

This guide helps you evaluate both options objectively so you can make the right choice for your circumstances.

What DIY Credentialing Requires

Time Investment

Self-managing credentialing takes significant time:

• Initial applications: 10-30+ hours per license or privilege application
• Follow-up: Ongoing tracking, phone calls, resubmissions
• Renewals: 2-5 hours per credential per renewal cycle
• Problem resolution: Highly variable when issues arise

Knowledge Required

Effective self-management requires understanding:

• State-specific licensing requirements
• Payer enrollment processes
• Hospital credentialing procedures
• Documentation requirements
• Deadline management

Organization Systems

You need systems for:

• Tracking expiration dates
• Storing documentation
• Managing application status
• Maintaining CAQH profile
• CME tracking

What Credentialing Services Provide

Core Services

Most credentialing services offer:

• Application completion: They fill out applications with your data
• Document management: Store and organize your credentials
• Tracking: Monitor application status and follow up
• Renewal management: Alert you to upcoming expirations
• CAQH maintenance: Keep your profile current

Additional Services

Some services also provide:

• Primary source verification coordination
• Payer enrollment assistance
• Hospital privilege applications
• Multi-state license coordination
• Problem resolution support

Service Models

Credentialing services operate under different models:

Cost Comparison

DIY Costs

Self-management has costs, just not in service fees:

• Time opportunity cost: What's your non-clinical hour worth?
• Stress cost: Administrative burden and worry
• Error cost: Mistakes can cause delays, lapses, lost revenue
• Application fees: Same whether DIY or service (you still pay them)

Service Costs

Credentialing services typically charge:

• Setup fees: $200-500 for initial onboarding
• Monthly fees: $50-200/month for ongoing management
• Per-application fees: $100-500 per application (some models)
• Annual packages: $500-2,000+/year for comprehensive service

The Math

Consider this calculation:

• If your time is worth $200/hour (clinical earnings)
• And DIY credentialing takes 40 hours/year
• That's $8,000 worth of your time
• A $1,500/year service saves you $6,500 in time value

Your numbers will vary—but do the math for your situation.

When DIY Makes Sense

Simple Situations

DIY is reasonable when:

• Single state license
• One hospital affiliation
• Limited payer mix
• Stable practice (few changes)
• Clean credential history

Available Time

DIY works if you:

• Have administrative time available
• Don't mind the work
• Are organized by nature
• Can respond quickly to requests

Cost Sensitivity

DIY may be necessary if:

• Budget is very constrained
• You're early in career with limited income
• Employer doesn't provide support or reimbursement

When to Outsource

Complexity Indicators

Outsourcing makes sense with:

• Multiple states: Each state adds tracking burden
• Multiple hospitals: Different applications, timelines, requirements
• Many payers: Enrollment complexity multiplies
• Frequent changes: Practice transitions, locum work
• Complicated history: Malpractice claims, gaps to explain

Time Constraints

Outsource if you:

• Have no administrative time available
• Struggle with paperwork and deadlines
• Have missed expirations before
• Value clinical/personal time highly

Risk Factors

Outsourcing reduces risk when:

• Credential lapses would significantly impact income
• You've had problems with DIY management
• The cost of a mistake exceeds the cost of service

Evaluating Credentialing Services

Questions to Ask

When evaluating services:

1. What exactly is included in the fee?
2. Who will be handling my account?
3. How do you communicate updates and requests?
4. What's your success rate/turnaround time?
5. How do you handle problems or denials?
6. Can I see a sample dashboard or tracking system?
7. What happens if I'm unsatisfied?

Red Flags

Be cautious of services that:

• Guarantee specific timelines (they can't control boards/payers)
• Won't explain their process
• Have no clear communication protocols
• Lack references or testimonials
• Require long-term contracts with no exit

What Good Services Provide

Look for:

• Dedicated account manager or clear contact
• Online portal for status tracking
• Proactive communication
• Clear documentation of what they've done
• Transparent pricing

Hybrid Approaches

Software + DIY

Middle-ground option:

• Use credentialing software for tracking
• Handle applications yourself
• Lower cost than full service
• Better organization than pure DIY

Selective Outsourcing

Outsource only the complex parts:

• Handle simple renewals yourself
• Use service for new state licenses
• Use service for payer enrollment
• DIY for straightforward items

Employer Support

Many employers provide:

• Credentialing staff support
• Payer enrollment handling
• Privilege application assistance
• Check what's available before paying separately

Making the Decision

Decision Framework

The Bottom Line

If you have:

• Simple situation + available time + organizational skills: DIY is reasonable
• Any complexity + time constraints + past issues: Outsourcing pays for itself

Conclusion

DIY credentialing works for physicians with simple, stable practices who have administrative time and organizational skills. Outsourcing makes sense when complexity increases, time is limited, or past self-management has caused problems.

Don't just look at the service fee—calculate the cost of your time and the risk of errors. A $1,500 annual service that prevents a $10,000 revenue loss from a missed renewal is a good investment. A $1,500 service for a straightforward situation you could easily manage yourself may not be.

Evaluate your specific situation honestly. The right answer depends on your complexity, available time, organizational abilities, and risk tolerance.

Key Takeaways

• DIY requires time: 40+ hours annually for moderate complexity
• Services cost $500-2,000+/year: Varies by scope and model
• Calculate your time value: DIY isn't "free"
• Complexity drives decision: Multi-state, multi-hospital favors outsourcing
• Past performance matters: If DIY has caused issues, change approach
• Hybrid options exist: Software + DIY, selective outsourcing

References

[1]: Medical Group Management Association - Credentialing Benchmarks https://www.mgma.com/

[2]: AMA - Practice Management Resources https://www.ama-assn.org/