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Medical Billing Case StudySeamless Credentialing for a Multi-Provider Practice with Billed Right
This case study explores how Billed Right is managing credentialing for one physician and three mid-level providers across 20+ payers. 75% of applications are already approved or scheduled, zero have been rejected, and the project is still in progress.
Our Client
A Florida-based sleep medicine group with one physician and three mid-level providers, averaging $50K–$100K in monthly revenue and carrying $645K+ in aged accounts receivable that needed to be addressed alongside credentialing.
Turning to Billed Right
- Needed fast, low-effort credentialing completed across 20+ insurance payers without burdening internal staff
- Wanted to reduce the administrative strain credentialing was placing on the clinical and front-office team
- Required alignment with their existing tools, eClinicalWorks and Trizetto, without any system disruption
- Sought a long-term RCM partner who could support ongoing revenue cycle goals beyond the initial credentialing engagement
The Challenges
What was holding this practice back before Billed Right.
Inconsistent credentialing processes: no centralized system for managing applications for a physician and three NPs across 20+ payers simultaneously
Manual, time-consuming workflows: every application was tracked and submitted by hand, creating errors, omissions, and inefficient use of staff time
Lack of expertise with complex payers: navigating specific requirements for Tricare, Medicare, and Medicaid was creating delays and incomplete submissions
Credentialing delays impacting billing: slow credentialing was directly delaying billing capability with key payers, disrupting cash flow and revenue cycle continuity
Compliance risk: inaccurate or incomplete submissions were exposing the practice to payer denials, rework, and potential compliance issues
No proactive payer follow-up: applications were submitted but not systematically tracked, leaving the practice unaware of status or pending issues
Our Response
What Billed Right implemented to move credentialing forward.
- Took full ownership of the credentialing process, implementing a centralized tracking and submission system that covers all applications for the physician and three NPs simultaneously across 20+ payers. This eliminated the disorganization and created a single source of truth for application status
- Deployed a credentialing team with deep expertise in complex payer requirements, specifically Tricare, Medicare, Medicaid, and UHC, to ensure all applications were submitted correctly and completely on the first pass, reducing the risk of rejection before it could occur
- Accelerated billing capability with key payers by managing the credentialing process on a priority schedule. This let the practice begin billing sooner, protected cash flow, and minimized disruption to the revenue cycle during the credentialing window
- Took responsibility for all payer follow-up communication, proactively tracking every application, resolving issues as they arose, and keeping the client informed at every stage without requiring them to chase payer contacts themselves
- Conducted thorough compliance reviews of every application using a customized credentialing checklist, ensuring all submissions met the latest payer-specific requirements and eliminating the compliance risk that had previously put the practice at risk of denials and rework
The Results
Outstanding outcomes, and the engagement is still in progress.
This case study is still in progress. The numbers above reflect performance mid-engagement, and we expect final results to improve further as remaining applications clear.
Why This Client Chose Billed Right
Fast Approvals, Minimal Rejections
The client was drawn to our track record of fast approvals and zero rejections, which ensured no disruption to their revenue cycle during the credentialing period.
Proactive Communication
Billed Right's proactive updates and clear communication kept the client informed at every stage: no chasing payers, no status uncertainty.
Complex Payer Expertise
Our experience with Medicare, Medicaid, UHC, and Tricare gave the client confidence that even the most complex payer applications would be handled correctly.
End-to-End Ownership
Our full-service approach allowed the clinical team to focus on patient care while we managed every aspect of credentialing from initial submission through final approval.
Ongoing Commitment
We continue to work with this client on:
- Continuing to manage all outstanding applications through final approval
- Proactive re-credentialing tracking and expiration management
- Payer follow-up and escalation for any delayed applications
- Alignment with long-term RCM goals as the engagement evolves
- Support for additional provider credentialing as the practice grows
- Integration with eClinicalWorks and Trizetto maintained throughout
Credentialing delays cost practices revenue every day an application sits unresolved. Billed Right takes full ownership of the process so your team does not have to.
Common Questions About This Case Study
Provider credentialing is the process of verifying a physician's or mid-level provider's qualifications and enrolling them with insurance payers so the practice can legally bill and be reimbursed for the care they provide. Until credentialing with a given payer is complete, the practice generally cannot bill that payer for a provider's services, which means credentialing delays translate directly into delayed or lost revenue.
Billed Right is managing credentialing across more than 20 payers simultaneously for one physician and three mid-level providers at this sleep medicine practice, including complex payers such as Tricare, Medicare, Medicaid, and UHC.
Billed Right deployed a credentialing team with deep expertise in complex payer requirements and used a customized compliance checklist to review every application before submission. Submitting each application correctly and completely on the first pass eliminated the rejection risk that typically comes from incomplete or improperly formatted credentialing submissions.
Timelines vary by payer and provider type, but Billed Right manages the process on a priority schedule designed to get providers billing with key payers as early as possible. In this case study, 75% of applications across 20+ payers were already approved or scheduled while the engagement was still in progress.
Yes. In this case study, Billed Right managed credentialing simultaneously for one physician and three mid-level nurse practitioners across the same payer network, using a centralized tracking system to keep every application organized regardless of provider type.
Related Resources
Credentialing Services
Learn how Billed Right manages credentialing for medical practices.
Learn moreAuthorizations Services
Prior authorization management to prevent billing disruptions.
Learn moreAR Follow-Up Services
Recover aged AR while credentialing gets resolved.
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