We optimize PECOS submissions, flag common CMS issues, and utilize escalation channels when approvals are stalled.
Credentialing is the gateway to revenue—yet 60% of providers face delays of 90 days or more due to paperwork errors, missed updates, or payer backlogs. At ConnecticutMedBill, we take over the process so you can focus on patients, not chasing insurance approvals. From Medicare/Medicaid enrollment to commercial payer contracts and CAQH management, we ensure that your applications are submitted cleanly, tracked constantly, and approved more efficiently.
Average approval time cut by 25–30% compared to in-house processing.
Reduced risk of denials and costly enrollment gaps.
Full visibility with progress updates at every stage
Credentialing looks like paperwork, but it’s a revenue gatekeeper. A single missing license or mismatched name can delay network enrollment for months. Practices commonly miss the window where the bulk of their first-year revenue is captured — and that lost income usually never returns.
We focus on closing that gap — fast, clean files; proactive payer communication; and measurable outcomes.
1. Intake & audit (Day 0–3): collect provider demographics, licenses, certificates, malpractice info, W-9, NPI, DEA, CDS (if applicable), board certificates, résumé, hospital privileges, and CAQH access. We conduct a completeness audit on the spot, ensuring that nothing goes out missing.
2. Parallel submission strategy: While the CAQH and PECOS updates process is underway, we prepare payer-specific packets (commercial, Medicare, Medicaid) and submit them to each payer’s portal or credentialing contact in parallel — not sequentially.
3. Active payer management: weekly case notes, escalation paths, and direct follow-ups to credentialing reps. We close the loop on any documentation requests within 24–48 hours.
4. Revalidation & maintenance: automated reminders, re-credentialing preparation 90 days before expiry, and immediate updates to CAQH/PECOS when provider details change.
Result: We typically shorten the credentialing lifecycle by 25–30% compared to standard in-house timing for comparable payers.
We integrate with your practice management system or EHR whenever possible to minimize duplicate data entry and ensure consistent claim-ready information.
You receive a dashboard and a biweekly status summary until the provider is fully in-network with all the requested payers.
We also prepare remediations for retroactive denials — if credentialing paperwork produced a valid paid claim that was denied, we build the appeal.
Credentialing is a revenue conversion play. When done right, it turns months of unpaid work into real cash flow. ConnecticutMedBill helps practices:
Cut credentialing time by ~25–30%.
Reduce application errors to under 10%.
Minimize out-of-network losses during ramp-up.
Typically 90–120 days, but many payers process claims in 45–75 days with a complete packet — we aim for the faster end of this range.
Yes — we enroll both individual providers and facilities (ASC, clinic, hospital affiliations).
We investigate the denial, correct any deficiencies, and resubmit; if needed, we escalate the issue to payer credentialing supervisors.
Yes. We proactively manage renewals and send notices 90 days before expiration.
We optimize PECOS submissions, flag common CMS issues, and utilize escalation channels when approvals are stalled.
