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
Provider credentialing is the process of verifying a provider’s licenses, certifications, qualifications, and other credentials with insurance payers so the provider can bill services in-network and get reimbursed. It is the starting point of the revenue cycle. When credentialing is delayed, incomplete, or mismanaged, providers lose months of billable income, render services out-of-network, and practices face avoidable financial risk, claim denials, and write-offs. Proper credentialing ensures providers can bill confidently, avoid denials, secure timely reimbursements, and stay compliant with payers.
Typical new credentialing timelines average 90 to 120 days per payer, with primary delays caused by incomplete applications, missing documents, or payer follow-up failures. These delays can cost practices tens of thousands of dollars per month in lost collections. Medhasty shortens timelines by 25 to 30 percent compared to in-house handling through structured intake, parallel submissions, continuous payer engagement, active follow-ups, and proactive management. This results in faster approvals and reduced revenue loss during provider onboarding.
Medhasty provides comprehensive end-to-end services including Initial Provider Enrollment, Re-credentialing and Ongoing Maintenance, CAQH Profile Setup and Management, Medicare and Medicaid Enrollment, Commercial Payer Enrollment, Group and Facility Credentialing, Compliance Monitoring, and Credentialing Cleanup and Recovery for stalled or denied applications. They take full ownership of the entire process from Medicare, Medicaid, and commercial payers to CAQH, ensuring applications are accurate and actively managed until approval.
Initial Provider Enrollment is managed end-to-end by Medhasty. They ensure providers are approved and correctly linked to payers before any claims are submitted. This includes collecting and validating all required data, submitting applications accurately, and following up until the provider is fully enrolled and able to bill in-network.
Medhasty monitors payer re-credentialing cycles proactively and manages renewals to prevent any enrollment lapses. They track expiration dates for licenses, DEA registrations, malpractice policies, and certifications continuously, ensuring providers remain compliant and in-network without gaps throughout the year.
Medhasty creates, updates, verifies, and attests CAQH profiles on a regular basis to keep them payer-ready at all times. They handle ongoing maintenance so profiles do not become inactive or outdated, which is a common cause of delays in credentialing approvals.
Yes, Medhasty fully manages Medicare and Medicaid enrollments. This includes handling PECOS submissions using forms such as CMS-855I and CMS-855R, as well as state-specific Medicaid portals. They simplify these complex processes with accurate filings, queue monitoring, and active follow-up to achieve faster in-network approval.
Medhasty manages applications with major commercial insurance carriers. They ensure contracts align correctly with the provider’s specialties, locations, and practice details to avoid mismatches that could delay approval or cause future claim issues.
Yes, Medhasty supports group practices, multi-provider enrollments, Ambulatory Surgery Centers (ASCs), clinics, and hospitals. They use structured multi-provider enrollment workflows and parallel submissions to streamline the process and reduce bottlenecks across multiple locations or providers.
Compliance Monitoring involves continuous tracking of licenses, DEA registrations, malpractice policies, certifications, and CAQH attestations. Medhasty provides complete audit trails for every submission, secure encrypted document storage, proactive revalidation tracking, and guidance on risks such as expired licenses or enrollment gaps to protect practices from compliance issues and audit problems.
For stalled, denied, or misfiled applications, Medhasty identifies the root issues, corrects errors such as data mismatches, and re-engages payers to regain approval. They also address backlogged applications to minimize revenue loss and get providers billing as quickly as possible.
Medhasty combines expert oversight with proven platforms including CAQH ProView for profile setup and attestations, PECOS and CMS portals for Medicare enrollments, payer and clearinghouse portals such as Availity and Change Healthcare for faster status checks, centralized Credentialing Trackers and Dashboards for case management and reminders, and HIPAA-compliant Secure Document Vaults for document sharing. These tools provide real-time visibility and reduce delays.
Yes, Medhasty integrates with EHRs and Practice Management Systems to ensure a smooth medical credentialing process. This integration helps maintain accurate data flow, reduces manual entry errors, supports real-time updates, and creates a seamless experience between credentialing and billing operations.
Medhasty focuses on revenue-impacting metrics such as time to first payer approval, percentage of applications approved without revision (with a target of 90 percent or higher), time to first paid claim after credentialing, reduction in out-of-network claims, and average number of documentation requests per application. Clients receive regular status updates and access to a clear dashboard until all requested payers are fully active.
Medhasty treats credentialing as a project with defined milestones, accountability, and escalation paths. The process begins with Intake and Completeness Audit in the first 0 to 3 days. They collect all required provider and practice data, immediately audit it for completeness and accuracy, and validate everything internally before any submission. Nothing is sent to payers until the file is clean and complete, which significantly reduces back-and-forth delays.
Medhasty collects and verifies Government ID and State Licenses for exact name and credential matching, NPI numbers along with Taxonomy codes and Practice Addresses to prevent mismatches, DEA and Controlled Substance Registrations for prescribing privileges, Board Certifications and Training History to accelerate specialty approvals, W-9 and Tax Documentation for EFT setup and payments, and Hospital Privileges or Facility Contracts when applicable. They maintain a secure credentialing tracker that flags missing items and identity mismatches early.
Common bottlenecks include data mismatches such as name, NPI, or TIN across systems, inactive or outdated CAQH profiles, provider availability delays for signatures, complex state Medicaid requirements, and unfavorable or misaligned payer contracts. Medhasty fixes these through standardized verification across all payer systems, ongoing CAQH management and attestations, coordinated e-signature and delegated workflows, state-specific filing with queue monitoring, and identification of reimbursement gaps with correction strategies.
Practices typically experience 25 to 30 percent faster credentialing timelines, significantly fewer enrollment-related claim denials and write-offs, clear real-time visibility with status updates and tracking, reduced revenue loss during onboarding, higher first-pass approval rates, and stronger overall compliance. Credentialing done correctly converts time into revenue and helps practices get paid faster while staying in-network.
If an application is denied or stalled, Medhasty immediately identifies the specific issue, corrects any errors, and re-engages the payer to regain approval. They also handle backlogged or incorrectly filed applications, support retroactive corrections where applicable, and work to minimize any resulting revenue loss so providers can resume in-network billing quickly.
After initial approval, Medhasty continues proactive monitoring of license expirations, DEA registrations, malpractice coverage, and CAQH attestations. They provide continuous revalidation tracking, secure document storage, complete audit trails, and guidance on potential risks. This year-round approach prevents compliance gaps and keeps providers fully enrolled without lapses.
Practices can start by requesting a free credentialing audit or beginning the credentialing process directly through Medhasty’s contact channels. Their team will perform an initial review, collect necessary information, and guide the practice through the structured intake and full enrollment process to get providers in-network faster and protect revenue.
Let our medical billing experts optimize your revenue cycle management. We enable healthcare practices to increase cash flow and avoid denials. Permanently!
