Credentialing5 min read
Credentialing vs. Enrollment: What's the Difference?
The two terms are often used interchangeably, but they are separate processes with different owners and different outcomes. Here is how they fit together.
Revenue cycle management
Every dollar you earn should reach your account.
We manage the full revenue cycle for healthcare practices, from the moment a patient books to the day the payment posts, so your team can stay focused on care, not paperwork.
Claim progress
- EligibilityVerified
- Clean claimSubmitted
- Payment & ARFollowed up until paid
Every claim tracked
From submission to payment
- Full RCM services, start to finish
- Billing, denials & collections managed daily
- Credentialing included when you need it
- Real people working your claims
About us
We exist because getting paid is harder than it should be.
Most medical practices are leaving money on the table every month. Not because the care wasn't delivered, but because somewhere in the billing process, a claim got rejected, a denial went unanswered, or a balance sat in aging until it was too late to collect. Our job is to make sure that doesn't happen to you.
We're a Revenue Cycle Management company built around one goal: getting healthcare practices paid in full, on time, for every service they provide. We handle the entire billing cycle, from scheduling and eligibility checks before the visit to payment posting and AR follow-up after it, so nothing falls through the cracks.
Credentialing is part of what we do too. But our core focus is revenue. We track every claim, work every denial, and follow up on every outstanding balance until your money is where it belongs.
What's included
Your whole revenue cycle, with one team.
One team handles your entire revenue cycle, so nothing gets lost between handoffs
We work inside your existing systems, so there's no disruption to your practice
You get regular reporting so you always know where your money is
We care about what reaches your bank account, not just what gets submitted
Our services
The full revenue cycle, covered.
Revenue cycle management isn't one thing. It's a series of steps that have to work together. Miss one, and claims pile up unpaid. We manage every part of the cycle so the whole thing keeps moving.
View all services
Appointment Scheduling
Think of scheduling as the first step in the revenue cycle, not a separate administrative task. When it's handled right, every step that follows is smoother.
What’s included
- Patient appointment booking and coordination
- Insurance and provider matching at the point of scheduling
- Demographic and insurance data capture
Insurance Verification
We verify every patient's insurance details ahead of their appointment, so when the claim is submitted, it's built on accurate, confirmed information.
What’s included
- Primary and secondary insurance confirmation before each visit
- Benefits verification and coverage limits review
- Co-pay, co-insurance, and deductible check
Eligibility Checking
Checking eligibility once at scheduling isn't enough. We run verification close to the date of service, so you're billing against coverage that's actually active when the patient walks in.
What’s included
- Real-time eligibility verification per scheduled visit
- Plan status and effective date confirmation
- Multiple payer checks for patients with dual coverage
Medical Billing
We prepare and submit clean claims on your behalf, and we track every one from the moment it leaves to the moment it's paid.
What’s included
- ICD-10 and CPT coding review and accuracy check
- Clean claim preparation and scrubbing before submission
- Medicare, Medicaid, and commercial payer billing
Claim Rejections
We review every rejection, find the root cause, correct it, and resubmit before it turns into a delay that affects your cash flow.
What’s included
- Rejection identification and root-cause review
- Claim correction and same-day or next-day resubmission
- Rejection trend reporting to identify and prevent repeat issues
Denial Management
We review every denial, categorize it by reason, and build the right appeal. Then we follow up with payers until the claim is resolved.
What’s included
- Full denial review and categorization by payer and reason code
- Appeal letter preparation and timely submission
- Payer follow-up through each stage of the appeals process
Payment Posting
We post all payments promptly and accurately, and we flag anything that doesn't match what the payer should have paid.
What’s included
- ERA (Electronic Remittance Advice) processing and auto-posting
- Patient payment posting and reconciliation
- Underpayment identification and payer follow-up
Accounts Receivable & Aging
We work your accounts receivable actively, prioritizing by age and value, and following up with payers and patients before balances fall into the danger zone.
What’s included
- AR aging report review and balance prioritization
- Payer follow-up on outstanding claims by age bucket
- Patient balance follow-up and statement management
Provider Credentialing
We manage credentialing and enrollment from start to finish, chasing payers when applications stall and keeping you updated at every stage.
What’s included
- NPI registration (Type 1 & Type 2) and CAQH profile setup
- Medicare, Medicaid and commercial payer enrollment
- Re-credentialing tracking and compliance management
Why choose us
We focus on revenue, not just paperwork.
Most billing companies submit claims and move on. We stay with each one until it's paid, and we look for every place in the cycle where money is leaking out.
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One team, start to finish
The same people who handle your eligibility checks also manage your denials and post your payments. Nothing gets lost in a handoff between departments.
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We know the payers
Commercial plans, Medicare, Medicaid: each has its own rules, portals, and quirks. We know them, and we work within them without slowing down.
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Fast follow-up, every time
We track every claim, every denial, and every outstanding balance on a regular schedule. Nothing sits waiting for someone to notice it.
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Clear reporting you can use
Regular reports that show where your money is: what's been paid, what's in dispute, what's still outstanding, and anything we're actively working on.
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We work in your systems
We work inside your existing EHR and practice management software. You don't need to change platforms or retrain your staff to work with us.
Our process
From onboarding to ongoing revenue, step by step.
We start by understanding where your revenue cycle is today. From there, we take over the day-to-day and keep improving as we go.
- 01
We review your current setup
We look at how your billing is running today: where claims are getting stuck, what's sitting in aging, and where money is going uncollected. We identify the biggest issues and agree on what to tackle first.
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We get your systems in order
If credentialing or payer enrollment is needed, we start there. We also take over or set up your billing systems so everything flows through one consistent, tracked process.
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We take over the day-to-day
From scheduling and verification through to billing, posting, and collections, we run the full cycle. You focus on patients; we focus on making sure you get paid for seeing them.
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We track, report, and keep improving
We send regular performance reports and keep refining the process. If a payer is causing more denials than usual, we address it. If AR days are creeping up, we act on it before it becomes a bigger problem.
Who we serve
Practices of every size and specialty.
Whether you're a solo provider or a multi-location group, the revenue cycle works the same way, and the gaps cost everyone the same.
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Primary care & family medicine practices
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Mental health, behavioral health & psychiatry clinics
- 03
Specialty groups: cardiology, orthopedics, pain management, dermatology & more
- 04
Solo providers who need a billing team without the overhead
- 05
Multi-provider groups managing multiple locations
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Telehealth & virtual care practices
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Urgent care and ambulatory clinics
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New practices setting up billing from scratch
Educational resources
Practical guidance for practice leaders.
Simple guides that explain how billing, credentialing and getting paid actually work.
Downloadable guide
New Practice Launch Checklist
A working checklist covering the credentialing, enrollment and billing groundwork to sort out before you see your first patient.
FAQ
Answered before you have to ask.
Still have a question?
Tell us about your practice and we will point you in the right direction.
Contact usMost practices can be onboarded within one to two weeks. If credentialing is also needed, that timeline depends on the payers involved, but in many cases we can begin billing for services while enrollment is still in progress, so there's minimal disruption to your cash flow.
Yes. We work inside the practice management and EHR systems you're already using, including Athena, Kareo, AdvancedMD, and most others. You don't need to switch platforms or retrain anyone on your team.
A rejection comes back before the claim is processed, usually because of a technical error like a wrong patient ID, a missing modifier, or a formatting issue. A denial comes after the payer has reviewed the claim and decided not to pay it. Both need to be worked, but the resolution is different. We handle both.
Credentialing and billing run as parallel tracks. Where a provider is already enrolled with some payers, we can begin billing through those while credentialing applications are pending with others. We keep you updated on the status of each so you know exactly when each payer goes live.
We send regular performance reports covering claim volume, payment rates, denial rates, AR aging, and any issues we're actively working on. If something needs your attention, we flag it before it becomes a problem.
We work with practices on flexible terms. Most of our clients stay because the results speak for themselves, not because they're locked in. We're happy to talk through the arrangement that makes the most sense for your practice size and situation.
Free consultation
Ready to stop leaving money on the table?
Talk to us about your practice. We'll look at where your revenue cycle stands today and give you an honest picture of what we can improve.
- Pick a date and time that suits you
- Confirmation and calendar invite by email
- Talk through your billing, denials and collections
Book a call