Solo Practitioner vs. Group Practice: Credentialing Requirements Compared
Provider credentialing is more than just paperwork. It is a critical process that determines whether a healthcare professional or practice can legally and ethically serve patients and receive reimbursement from insurance companies. Whether you are a solo provider starting your own clinic or a part of a group practice, understanding the differences in solo vs group credentialing is key to avoiding delays and ensuring compliance.
At Instapay Healthcare Services, we provide end-to-end medical billing and RCM support, including expert guidance through the credentialing process. In this blog, we break down the credentialing requirements for solo practitioners and group practices, so you can make informed decisions for your practice setup.
What is Provider Credentialing?
Provider credentialing is the process of verifying a healthcare provider’s qualifications, including education, licensure, training, work history, and any malpractice or disciplinary records. Insurance payers require this information before allowing a provider or practice to join their network and bill for services.
This process must be completed whether you operate independently as a solo provider or as part of a group practice. However, the steps and complexity can vary based on the structure of your practice.
Credentialing for Solo Practitioners
A solo practitioner is an individual healthcare provider who owns and operates their own practice independently. In this setup, the provider is responsible for all aspects of the credentialing process
Key credentialing requirements for solo providers include:
While group practices must credential each provider individually, they also need to submit organizational documents and ensure that all providers are correctly linked to the group contract. This makes group credentialing more complex, but it often allows for streamlined billing and improved payer relationships.
Instapay Healthcare Services specializes in managing these complexities, ensuring every provider in your group is properly credentialed and linked to the practice for smooth reimbursement.
Solo vs Group Credentialing: What’s the Difference?
The primary difference between solo vs group credentialing lies in the structure and scope of the enrollment process.
| Factor | Solo Provider | Group Practice |
|---|---|---|
| NPI Type | NPI-1 only | NPI-1 (individual) + NPI-2 (group) |
| Billing | Under individual | Under group and provider |
| Credentialing | Individual only | Individual + group |
| Complexity | Lower | Higher |
| Admin Load | High (for one person) | Shared (across team or RCM partner) |
Both setups require accuracy, follow-ups, and regular re-credentialing to stay compliant. Choosing between solo and group practice depends on your business goals, but in either case, professional credentialing support can save you time, reduce denials, and accelerate cash flow.
Let Instapay Handle Your Credentialing
At Instapay Healthcare Services, we take the stress out of provider credentialing, whether you are a solo provider or part of a group practice. Our team ensures your credentialing applications are submitted correctly, tracked consistently, and maintained over time, so you can focus on patient care, not paperwork.
Ready to simplify your credentialing?
At Instapay Healthcare Services, we take the stress out of provider credentialing, whether you are a solo provider or part of a group practice. Our team ensures your credentialing applications are submitted correctly, tracked consistently, and maintained over time, so you can focus on patient care, not paperwork.
Contact Instapay Healthcare Services today for a free consultation.
