In-House vs Outsourced Medical Credentialing: Which Is Better for Growing Practices?

• Admin
• 16 Dec 2025

For growing practices, the choice is between two aspects, either building an in-house credentialing team or choosing to outsource medical credentialing. Each path comes with its own merits, but only one aligns seamlessly with long-term growth, agility, and financial sustainability.

In this blog, we’re going to break down both approaches and help you determine what’s truly better for a growing practice.

Let’s Understand the Stakes of Medical Credentialing

As a task, medical credentialing is not a one-time thing. It is a continuous and detailed process. It involves:

• Provider enrollment with insurance payers
• Verifying education, licenses, certifications, and work history
• Ongoing re-credentialing and compliance updates
• Managing payer-specific rules and timelines

Any delay or error can result in denied claims, delayed reimbursements, and lost network participation. For growing practices, when new providers, locations, and specialties are added, these risks multiply over time.

In-House Medical Credentialing - Gives Control but with Hidden Costs

Control can be a dangerous thing. Various practices opt for managing credentialing on their own with internal processes to maintain control. There is a possibility that this approach might work for small practices with minimal provider turnover. However, as the operations expand, this approach becomes a bottleneck.

Pros of In-House Credentialing

• Direct oversight of the credentialing process
• Immediate internal communication
• Familiarity with internal workflows

Cons of In-House Credentialing That Impact Growth

• High operational costs (staff salaries, training, tools)
• Dependency on a limited number of trained employees
• Increased risk of burnout and human error
• Slower turnaround times during expansion
• Difficulty keeping up with constantly changing payer requirements

With growing practices, in-house teams often face difficulties in scaling efficiently. This leads to many healthcare providers reconsidering whether the internal management is worth the strain.

Outsourced Medical Credentialing - Built for Better RCM

When you choose outsourced medical credentialing services like Altermed RCM, you are unloading a highly complex function to experts.

Professional credentialing partners bring structured systems, payer expertise, and proper monitoring to you. In this way, your internal team has more time to focus on patient care and growth strategies.

Key Merits of Outsourcing

1. Faster Provider Enrollment

When you outsource medical credentialing, you are getting experienced teams that understand payer workflows, documentation nuances, and follow-up protocols. This significantly reduces enrollment timelines.

2. Reduced Administrative Burden

Credentialing is resource-intensive. Outsourcing eliminates internal staffing pressures, training cycles, and dependency risks.

3. Improved Accuracy & Compliance

Credentialing errors can be really costly. Professional teams offering outsourced credentialing services ensure strict quality checks, documentation audits, and on-time deadline tracking.

4. Cost Efficiency at Scale

Instead of fixed overhead costs, outsourcing offers predictable pricing—ideal for practices adding providers or expanding locations.

5. Better Revenue Flow

Accurate credentialing ensures providers can bill payers without interruption. This protects cash flow and reduces claim denials.

Thought Process Behind Outsourcing Decisions

It is not the growing demand which fails healthcare practices. The reason is operational overload. Healthcare leaders who choose to outsource medical credentialing demonstrate strategic clarity. It means that they understand where their internal energy is going to deliver the highest value.

Credentialing, although critical, does not require emotional intelligence, creativity, or patient interaction. However, it demands precision, consistency, and constant expertise. Delegating this function reduces cognitive load on leadership and staff, enabling clearer focus on:

• Patient experience
• Provider satisfaction
• Service expansion
• Long-term profitability

A hallmark of mature healthcare organizations is a shift from “doing everything internally” to “doing the right things internally.”

In-House vs Outsourced: A Quick Comparison 

Aspect	In-House Credentialing	Outsourced Credentialing
Scalability	Limited	Highly scalable
Cost Structure	Fixed & increasing	Predictable & flexible
Expertise	Staff-dependent	Industry specialists
Turnaround Time	Often slower	Faster, payer-optimized
Compliance Risk	Higher	Lower
Growth Readiness	Moderate	High

As healthcare practices grow, one operational decision quietly determines how fast and safely they’ll grow. It is medical credentialing. While it may not be evident to patients, credentialing directly impacts revenue flow, payer participation, and provider credibility.

Why Growing Practices Choose Altermed RCM

Healthcare practices that want to grow without any operational friction, Altermed RCM is designed for them. The team specializes in end-to-end medical credentialing solutions. When you outsource credentialing services to us, our approach is built on accountability, transparency, and measurable results.

What Sets Altermed RCM Apart as Your Credentialing Partner

• Dedicated credentialing specialists per client
• Proactive payer follow-ups and status reporting
• Expertise across multiple specialties and payers
• Better coordination with medical billing workflows
• Continuous re-credentialing and compliance monitoring

When you outsource medical credentialing to Altermed RCM, you’re doing more than just delegating a task; you’re gaining a strategic partner who is invested in your revenue integrity.

Final Verdict: Which Is Better for Healthcare Practices?

For practices focused on expansion, speed, and financial stability, outsourcing is no longer just an option—it’s a strategic decision. You might notice that in-house credentialing teams manage well initially, but this approach rarely keeps pace with long-term growth.

By choosing to outsource credentialing services, practices gain operational freedom, reduce risk, and create more space for patient-centered care.

Growth doesn’t come from doing more; it comes from working smarter. For most growing healthcare practices, outsourcing medical credentialing is the smarter path forward.