PanelGuard

Idea

A compliance monitoring copilot that stops solo and small-group therapy practices from silently losing their insurance panel status. PanelGuard tracks each clinician's CAQH ProView 120-day re-attestation clock and every payer's own revalidation cadence, sends redundant SMS and email alerts before anything lapses, and gives a one-click way to log proof of completion. It is priced and built for the 1 to 10 clinician practice that has no credentialing staff, not the hospital system or telehealth staffing company that Medallion and Verifiable are built for.

Market gap

CAQH ProView requires every enrolled provider to re-attest every 120 days. Miss it and the profile deactivates. Payers do not send a warning: claims for panels you are already on keep processing normally right up until they do not. Practice owners describe the problem as invisible until the revenue stops. Existing credentialing platforms (Medallion, Verifiable, IntelliCred) are managed-service platforms built for multi-state health systems and telehealth staffing companies, priced and onboarded for that buyer. CAQH ProView itself is free but purely passive: a profile, not a monitoring system. Nothing sits between the two serving the solo therapist or 3-person group practice who is currently tracking this in a spreadsheet or a sticky note, which is exactly the gap credentialing-industry guides point to when they call spreadsheet tracking "the single highest-value feature gap." Timing: insurance-based private practice has grown steadily as cash-pay-only models get harder to sustain, so more solo clinicians are now carrying CAQH and multi-payer revalidation obligations for the first time with no admin staff to own it.

Total Addressable Market (TAM)

Bottom-up, from the provider side:

• US behavioral health clinicians in active practice (clinical psychologists, LPCs, LMFTs, LCSWs, counselors): approximately 600,000, an aggregate figure built from BLS occupational data and workforce surveys.
• Assumption: roughly 50% work solo or in a small group private practice rather than exclusively in a hospital, agency, or school setting: approximately 300,000. This is an industry-consensus estimate stated explicitly as an assumption, not sourced to a single study.
• Assumption: roughly 70% of those accept at least one insurance panel rather than running cash-pay only: approximately 210,000 addressable providers who carry a live CAQH/payer-revalidation obligation.
• ACV: $348/year ($29/month, Solo tier list price).

TAM = 210,000 x $348 = approximately $73.1M/year.

SAM: practices that already pay for at least one other practice-management tool (SimplePractice, TherapyNotes, TherapyAppointment), which signals existing willingness to pay for software rather than run everything on paper. Assumption: 40% of the addressable 210,000 = 84,000 providers.

SAM = 84,000 x $348 = approximately $29.2M/year.

SOM: realistic self-serve capture in the first 12 to 24 months, 1 to 2% of SAM = 840 to 1,680 paying providers.

SOM = approximately $292K to $585K ARR.

Monetization strategy

Per-provider monthly SaaS subscription. The practice owner pays, not the insurance payer or the client, so the payer is the same person feeling the pain of a missed deadline. They keep paying because the alternative is a spreadsheet and a $38,000 mistake, not because of a switching-cost lock-in.

Pricing strategy

• Free: Credentialing Health Check, one-time or manually re-run. Lead magnet, not a trial.
• Solo, $29/month per provider: monitoring and alerts for up to 5 payer panels, one-click attest logging, audit history.
• Group, $99/month for up to 5 providers, then $15/month per additional provider: shared practice dashboard, one view across every clinician and every payer.
• Anchor: the Group tier is priced against the part-time credentialing coordinator role practices currently hire for, which job postings show running well over $800 to $1,500 a month even at 10 to 15 hours a week. $99 to $150 a month next to that looks trivial.
• Entry point: the free Health Check converts into Solo once a clinician sees their own at-risk dates.

Lead magnet

A free "Credentialing Health Check." A clinician enters their last CAQH attestation date and lists their payer panels. PanelGuard instantly emails a personalized report flagging every deadline at risk in the next 90 days, plus a one-page downloadable compliance calendar PDF. No account required to get the report, which matches how DocDrift and LandedIQ both used a no-signup instant-value tool as their opening move.

Social proof that the problem exists

• Medallion reviews on G2: real user complaints about inconsistent work quality from account-manager turnover, incomplete CAQH field syncing, and core features gated behind higher pricing tiers, showing the existing enterprise-oriented tool is a poor fit and a pain point even for practices that can afford it.
• Insurance Credentialing Specialist job postings on ZipRecruiter and the Credentialing Specialist job description template on Indeed: practices are actively hiring humans, including part-time roles at small therapy groups, specifically to chase re-credentialing and CAQH by hand, which is direct evidence of budget already being spent on this exact problem.
• PayerReady's CAQH re-attestation guide: documents a real case of a solo provider with a clean record across 11 payers whose profile lapsed for under a month, resulting in over $38,000 in denied claims before anyone noticed, and states plainly that payers give no warning email when a profile deactivates.
• HireGaynell's explainer on the CAQH 120-day rule: confirms the mandatory 120-day re-attestation mechanism and the lack of any built-in proactive alerting from CAQH or the payers themselves.

Competitors

• CAQH ProView: the free, mandatory foundation every provider must maintain. Purely passive, one profile, no payer-specific revalidation tracking, no meaningful proactive alerting.
• Medallion: full managed credentialing and payer-enrollment platform for multi-state telehealth companies and larger medical groups. Priced and sold for that buyer, not a solo clinician.
• Verifiable / IntelliCred / CredentialMyDoc: built for hospitals, health systems, and staffing agencies managing dozens to thousands of providers.
• GetPaneled: behavioral-health-focused, but structured as a service to help a clinician get newly paneled with payers, not an ongoing monitoring layer for panels already held.
• TherapyPM's credentialing service: bundled, done-for-you enrollment service tied to their practice-management suite.

What competitors offer now

CAQH ProView gives every provider one shared profile and a single reminder email as re-attestation nears, with no payer-specific tracking layered on top. Medallion, Verifiable, and IntelliCred sell full-service, higher-touch credentialing operations: they will get you newly paneled, manage payer enrollment paperwork, and assign account staff, but that comes at enterprise pricing and an onboarding motion built for organizations with dozens of providers, and G2/Capterra reviews show real friction even for the customers who can afford it. GetPaneled and TherapyPM's credentialing service are structured around the one-time event of getting credentialed, not the ongoing job of never silently losing the credential you already have.

What can be done differently to attract customers

Sell insurance against the specific failure mode, not a credentialing service: "don't get silently dropped," not "we'll get you paneled." Price for the solo clinician and the 3-to-10-person group specifically, at a fraction of a part-time coordinator's wage, with self-serve setup under 10 minutes and no sales call. Lead with the free Credentialing Health Check so a clinician sees their own personal risk before being asked to pay anything. Distribute through the channels solo and small-group therapists already use to solve practice-management problems: private-practice Facebook groups, r/therapists, TherapyDen, and practice-building podcasts and newsletters, rather than competing for enterprise procurement attention against Medallion.