NIGP 94871: Physician Credentialing Services

NIGP 94871 Physician Credentialing Services, an Item code, encompasses comprehensive credentialing, enrollment, and clinical review services that state and local governments procure to manage physician and healthcare provider qualifications, payer relationships, and medical oversight functions. State and local agencies are actively soliciting under this code for medical staff credentialing platforms with primary source verification and re-credentialing cycles, payer enrollment and CAQH profile management for behavioral health and traditional healthcare workforces, clinical review services staffed by board-certified physicians to process prior authorizations and grievances, medical director services for emergency medical systems, and occupational health examination programs for public safety personnel. Issuing bodies span state health departments, county boards of commissioners, city health systems, certified community behavioral health clinics, regional health plans, and county correction facilities, with repeat activity from Florida and California jurisdictions including Seminole County, Hillsborough County, San Mateo County, and Inland Empire Health Plan.

Recent opportunities show geographic concentration in the Southeast and West. The Nevada Department of Health and Human Services issued RFP 40DHHS-S3757 for medical staff credentialing services covering a minimum of 120 healthcare providers with four-year contract performance through June 30, 2030, and proposals due April 7, 2026. Seminole County (Florida) posted RFP 527726GCM on July 8, 2026, for a Medical Director Services Agreement for its Emergency Medical Services System with proposals due August 5, 2026, a 12-month contract with renewal options, weighted evaluation across qualifications, experience, understanding/approach, and fee structure at 25 points each. Hillsborough County (Florida) issued ITB 2600315 on June 29, 2026, for comprehensive occupational wellness examinations serving Fire Rescue, with an estimated three-year value of $2,480,940 and bids due July 21, 2026, requiring staffing with a Medical Director, Advanced Practice Registered Nurse, Clinical Exercise Physiologist, and Sonographer. Gulf Coast Center (Texas) released RFP 060326CRED on June 24, 2026, for credentialing and enrollment services spanning behavioral health and healthcare workforce with HUB-qualified status eligible for up to 5 evaluation points and contract commencement anticipated July 1, 2026. Inland Empire Health Plan (California) posted RFP 25-06803 on April 16, 2026, for clinical review services requiring board-certified California-licensed physicians to process approximately 1,375 prior authorization cases and 82 grievances monthly with proposals due May 27, 2026, and one-year initial term with four one-year renewal options. Columbus Consolidated Government (Georgia) solicited RFP 26-0008 for inmate medical and pharmacy services at Muscogee County Prison with proposals due May 15, 2026, a two-year base term with three one-year renewal options, and current monthly cost of $95,537.71.