🩺 Credentialing Services Pricing Calculator
Every healthcare worker needs credentialing before they can work, and most facilities will pay you to handle it. This calculator, straight from Dee's How To Charge workbook, prices credentialing as a service: it builds your true hard cost per file from eleven components, compares three pricing models (per-file flat fee, tiered monthly retainers, and a la carte), stacks the three revenue layers (files, payer enrollment, ongoing monitoring), and then checks whether the business still profits after paying the person doing the work. Run your numbers once free; the $27 one-time unlock keeps every section live forever and includes the Excel workbook.
B · Your cost to credential one provider
Eleven hard-cost components per file. Know your true cost before you set a single price.
Market range: $40 to $75 for full national plus county criminal.
Market range: $55 to $80, lab-based with MRO review.
Free via Nursys or state boards; paid services $10 to $25.
OIG LEIE and SAM.gov are free; this covers your labor or software cost. CMS requires monthly screening.
Market range: $20 to $40 per employer.
Market range: $15 to $25 per institution.
Market range: $15 to $25 per reference.
Internal labor cost to review TB, Hep B, MMR, Varicella, Flu, COVID records.
$20 works for internal checklists; budget $30 to $50 for a paid testing platform.
Market range: $85 to $125, based on 3 to 4 hours at $24 to $30/hr.
Validated at 20+ files/month; per-file cost drops with volume.
C · Model 1: per-file flat fee
Your entry point. Easiest yes for the client, zero commitment.
Common range: $300 to $750 per file depending on thoroughness.
C · Model 2: monthly retainer (tiered)
Predictable recurring revenue. Watch the math: a tier only works when the retainer beats the included-file cost.
Premium tiers can offer a lower overage as a perk.
C · Model 3: a la carte (cost and price per component)
Facilities pick what they need. Highest per-component margins.
D · Layer 1: credentialing files
Your monthly volume for employment/compliance credentialing files.
D · Layer 2: payer enrollment
The premium upsell once you credential a provider: enrolling them with insurance payers.
Market range: $1,500 to $5,000+ depending on payers and complexity.
Estimate 10% to 30% conversion from Layer 1.
Payer enrollment takes 15 to 30 hours per provider.
D · Layer 3: ongoing monitoring
The recurring revenue engine: every credentialed provider stays in your monitoring system.
Market range: $15 to $50/provider/month.
Cumulative: every new file is a potential monitoring client.
Mostly automated after setup.
E · Comp plan: structure
For the person selling or delivering the service. W2 (base + commission) or 1099 (set base to $0).
The sheet's B141 dropdown: fixed dollars per file, or a percentage of the fee collected.
W2 only; $0 for 1099. National average $50K to $53K.
Market: $20 to $75/file. $25 for credentialers, $40 to $75 for salespeople.
W2: 3% to 10%. 1099: 10% to 20%.
Volume is the #1 lever. At 20, tight. At 30 to 40, the math opens up.
Optional. Set to 0 if no bonus applies.
E · Commission protection (holdback)
30 days standard; 60/90 for high-value; 0 for no holdback.
Industry: 3% to 10%. Use 5% if unsure.
Estimates for planning, not financial advice. Cost components and fee ranges are the workbook's guidance; your vendors and your market decide the real ones.
Does this resonate?
Credentialing gets you in the building. The platform builds the business.
If a compliance service with recurring monitoring revenue sounds like your kind of business, the platform can turn it into a real plan: positioning, service checklist, and the week-by-week path from first file to a full client roster.
Build my launch plan free →Good questions about this math
How much should I charge for credentialing?
The workbook's guidance for a complete credentialing file is $300 to $750 depending on thoroughness, against a typical hard cost around $335 per file. The calculator shows your exact margin at any fee, plus tiered retainer and a la carte alternatives so you can quote whichever model fits the client.
What do medical credentialing fees usually include?
A complete file covers background check, drug screen, primary-source license verification, OIG/SAM exclusion checks, employment and education verification, references, immunization review, skills competency, staff time, and software. The calculator itemizes all eleven cost components so nothing rides for free.
Is credentialing as a service really a standalone business?
Yes, because it is three revenue layers, not one: credentialing files open the door, payer enrollment is the premium upsell ($1,500 to $5,000+ per provider), and ongoing monitoring is the monthly subscription engine. The calculator totals all three so you see the full picture, not just the per-file margin.
Should I price per file, on retainer, or a la carte?
Start clients per-file (the easiest yes), move consistent senders to a retainer, and keep a la carte for facilities that only need specific components. Watch the retainer tiers closely: the calculator flags when a tier's included files cost more than the retainer charges.
Does this account for paying a credentialer or salesperson?
Yes. The comp plan section builds base plus commission (flat per file or percent of fee), applies a refund holdback, and shows net profit after comp across all three layers with a clear profitable-or-not verdict.
Do I get the Excel version?
Yes. The $27 unlock includes the standalone Credentialing Pricing workbook (the exact sheet from Dee's How To Charge master, with every formula live) plus the START HERE guide tab, yours to download and keep.
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