Credentialing Mistakes That Cost Providers Thousands

Credentialing delays are lost revenue

A new provider who sees patients before payer enrollment is complete generates claims that cannot be paid. Some payers allow retroactive billing to the effective date; many do not. With enrollment taking 60 to 180 days, a late start can cost a practice an entire quarter of a provider's collections.

The most expensive mistakes

• Starting enrollment after the provider's start date instead of 120 days before

• Letting the CAQH profile lapse; most payers pull from it and reject stale attestations

• Missing re-credentialing deadlines, which terminates network participation

• Submitting applications with mismatched names, addresses, or NPI data

• Failing to follow up; applications sit untouched without regular status checks

• Not linking the provider to every practice location and tax ID

A better process

Treat credentialing as a managed pipeline: a master tracker of every provider, payer, application date, status, and expiration; CAQH re-attestation every 120 days; weekly payer follow-up; and a 90-day advance alert for every re-credentialing date.

Simplify Billing Services manages credentialing and contracting for all our clients, including multi-state enrollment and hospital privileges. We track every deadline so your providers never lose network status or billable days.