Group Practice

A medical practice in which multiple healthcare providers share administrative resources, facilities, and often a group NPI number, and may be credentialed collectively with insurance payers.

A group practice is a healthcare organization where multiple providers practice together under a single legal entity, sharing resources like billing infrastructure, administrative staff, office space, and equipment. Group practices range from small two-physician practices to large multi-specialty groups with hundreds of providers. From a credentialing perspective, group practices add complexity because each individual provider in the group needs to be credentialed separately with each payer, but they are all billing under the group's tax ID and NPI Type 2 number. The group itself may also need to be enrolled as an entity with certain payers, particularly Medicare. When a new provider joins a group practice, the group needs to add that provider to their existing payer contracts. This process is sometimes called "adding a rendering provider" or "roster addition." Depending on the payer, this can be a quick administrative update or it can require the full credentialing process for the new provider. Group practices often have a credentialing coordinator or use a credentialing service to manage enrollment for all their providers. This makes sense because with 10 providers each enrolled with 15 payers, you are managing 150 credentialing relationships, each with its own re-credentialing cycle. Larger group practices may qualify for delegated credentialing, which can significantly speed up the enrollment process for new providers. If your group has a delegated credentialing agreement with a payer, you can credential new providers internally and have them start seeing patients while the payer's formal approval is still being processed. Medicare enrollment for group practices requires filing a CMS-855B (for the group entity) in addition to the CMS-855I (for each individual provider). Both must be current and linked for claims to be paid correctly.