Get In-Network Faster. Stay Compliant. Protect Your Revenue
Credentialing is not administrative paperwork—it’s the starting line of your revenue cycle. When credentialing is delayed, incomplete, or mismanaged, providers lose months of billable income and practices absorb avoidable financial risk.
At Medhasty Medical Billing Services, we take full ownership of provider credentialing and payer enrollment. From Medicare and Medicaid to commercial payers and CAQH, we ensure applications are accurate, actively managed, and approved without unnecessary delays—so you can bill confidently and get paid on time.
What practices are seen with Medhasty:
25–30% faster credentialing timelines compared to in-house handling
Fewer enrollment-related claim denials and write-offs
Clear visibility with real-time status updates and tracking
Credentialing often looks simple—until it stalls revenue. A mismatched name, expired license, or inactive CAQH profile can halt payer approvals for months. During that delay, providers frequently render services out-of-network, resulting in lost or unrecoverable revenue.
Industry benchmarks highlight the risk:
Average new credentialing timeline: 90–120 days per payer
Primary delay drivers: incomplete applications, missing documents, or payer follow-up failures
Revenue impact: delayed credentialing can cost practices tens of thousands per month in lost collections
Medhasty closes this gap with structured intake, parallel submissions, and continuous payer engagement—turning credentialing into a controlled, measurable process instead of a waiting game.
We treat credentialing as a project with defined milestones, accountability, and escalation paths.
We manage new enrollments end-to-end, ensuring providers are approved and linked correctly before claims are submitted.
We monitor payer recredentialing cycles and manage renewals proactively to prevent enrollment lapses.
We regularly create, update, verify, and attest CAQH profiles—keeping them payer-ready at all times.
From PECOS (CMS-855I, 855R) to state-specific Medicaid portals, we simplify the most complex enrollments.
We manage applications with major commercial carriers and ensure contracts align correctly with provider specialties and locations.
We support group practices, ASCs, clinics, and hospitals with structured, multi-provider enrollment workflows.
Licenses, DEA registrations, malpractice policies, and certifications are tracked continuously to prevent compliance gaps.
For stalled, denied, or incorrectly filed applications, we identify issues, correct errors, and re-engage payers to regain approval.
We combine expert oversight with proven platforms to reduce delays and improve tracking:
CAQH ProView: Profile setup, attestations, and maintenance
PECOS / CMS Portals: Medicare enrollments and updates
Payer & Clearinghouse Portals (Availity, Change Healthcare): Faster status checks
Credentialing Trackers & Dashboards: Centralized case management and reminders
Secure Document Vaults: HIPAA-compliant document sharing
We integrate EHRs and PMS to ensure a smooth medical credentialing process. These are:
We focus on metrics that directly impact revenue—not vanity numbers.
Time to first payer approval
Percentage of applications approved without revision (target: 90%+)
Time to first paid claim post-credentialing
Reduction in out-of-network claims
Average documentation requests per application
You receive regular status updates and a clear dashboard until all requested payers are fully active.
Credentialing directly affects audits and payer compliance. Medhasty ensures:
Complete audit trails for every submission
Secure, encrypted document storage
Continuous revalidation tracking
Guidance on risks related to expired licenses or enrollment gaps
If credentialing issues result in denied claims, we support retroactive corrections and appeals, where applicable.
We treat credentialing as a project with defined milestones, accountability, and escalation paths.
We collect and immediately audit all required provider and practice data, including licenses, certifications, payer access, and identifiers. Nothing is submitted until the file is complete and internally validated.
Submitting a single, clean packet significantly improves approval speed.
Government ID & State Licenses: Ensures exact name and credential matching across NPI and payer systems
NPI, Taxonomy & Practice Addresses: Prevents provider-to-location claim mismatches
DEA & Controlled Substance Registrations: Required for prescribing and many payer panels
Board Certifications & Training History: Accelerates specialty panel approvals
W-9 & Tax Documentation: Required for EFT setup and payment release
Hospital Privileges or Facility Contracts: Essential for facility-based billing
Medhasty maintains a secure credentialing tracker that flags missing items and identity mismatches—the most common causes of stalled enrollments.
Data mismatches (name, NPI, TIN): Standardized verification across all payer systems
Inactive or outdated CAQH profiles: Ongoing management and attestations
Provider availability delays: Coordinated e-signatures and delegated workflows
State Medicaid complexity: State-specific filing and queue monitoring
Data mismatches (name, NPI, TIN): Standardized verification across all payer systems
Unfavorable payer contracts: Identification of reimbursement gaps and correction strategies
Credentialing done right converts time into revenue. Medhasty helps practices:
. Shorten credentialing timelines by 25–30%
. Reduce application errors dramatically
. Minimize revenue loss during provider onboarding
FAQS
Credentialing is the process of verifying a provider’s licenses, certifications, and qualifications with payers. Proper credentialing ensures providers can bill in-network, avoid claim denials, and secure timely reimbursements.
Typical timelines range from 90–120 days per payer, but with Medhasty’s structured intake, parallel submissions, and active follow-ups, many providers are approved 25–30% faster than in-house efforts.
We manage PECOS (CMS-855I/855R), state Medicaid portals, and commercial carrier applications, ensuring accuracy, compliance, and faster in-network approval.
Medhasty handles enrollment for multi-provider practices, ASCs, clinics, and hospitals, streamlining parallel submissions and reducing bottlenecks.
We identify the issue, correct errors, and re-engage the payer to regain approval. Our team also addresses backlogged or misfiled applications to minimize revenue loss.
We track license expirations, DEA registrations, malpractice coverage, and CAQH attestations. Our proactive monitoring prevents gaps and keeps providers fully compliant year-round.
Let our medical billing experts optimize your revenue cycle management. We enable healthcare practices to increase cash flow and avoid denials. Permanently!
