Medical Billing Case Study
Seamless 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. With 75% of applications already approved or scheduled and zero rejections, the client is extremely satisfied with the smooth and efficient process — and the project is still in progress.
Location:
Orlando Florida
Specialty:
Sleep Medicine
Providers:
1
NPs:
3
Our Client
Background
A Florida-based sleep medicine group with one physician and three mid-level providers, averaging $50K–$100K in monthly revenue and facing $645K+ in aged A/R.
Turning to Billed Right
Needed fast, low-effort credentialing across 20+ payers
Wanted to reduce admin strain on internal staff
Required alignment with existing tools (eCW + Trizetto)
Sought a partner to support long-term RCM goals
Challenges
Their Struggle
The following were the key pain areas the practice was grappling with:
Inconsistent Credentialing Processes: The practice struggled with managing credentialing for a primary provider and three Nurse Practitioners (NPs) across 20+ insurance payers, leading to disorganization and delays.
Manual, Time-Consuming Workflows: The process of submitting and tracking applications for each payer was done manually, leading to errors, delays, and inefficient use of staff time.
Lack of Expertise with Complex Payers: Navigating the specific requirements of complex payers like Tricare, Medicare, and Medicaid was a challenge, resulting in frequent rejections or slow approvals.
Credentialing Delays Impacting Billing: Slow credentialing processes led to delayed billing capabilities, which in turn caused disruptions in the practice’s revenue cycle and patient care.
Compliance Risks: The practice faced concerns over compliance with payer-specific regulations, which put them at risk of denials or rework due to inaccurate or incomplete submissions.
Solutions
Our Response
Billed Right took over the credentialing process, implementing a centralized system to handle all applications for the primary provider and three Nurse Practitioners (NPs) across 20+ payers. This eliminated disorganization and ensured a smoother workflow.
Our team of credentialing experts, familiar with the nuances of payers like Tricare, Medicare, and Medicaid, ensured all applications were submitted correctly and processed quickly, reducing the risk of rejections.
By managing the credentialing process efficiently, Billed Right enabled the practice to start billing with key payers much sooner, minimizing disruptions to the revenue cycle and avoiding long-term delays in cash flow.
We took responsibility for regular communication with payers, ensuring every application was followed up on and any issues were resolved quickly. This proactive approach led to fewer delays and ensured the client was always in the loop.
Our team ensured that all applications met the latest payer requirements, reducing the risk of denials and maintaining compliance across all submitted applications. By conducting thorough reviews and using a customized checklist, we ensured accuracy from the start.
Why Client Chose Billed Right
Billed Right’s experience with complex payer networks, including Medicare, Medicaid, UHC, and Tricare, gave the client confidence in our ability to handle their credentialing needs.
Our end-to-end approach allowed the client to focus on patient care while we managed all aspects of credentialing, from submission to follow-up.
The client was drawn to our track record of fast approvals and minimal rejections, ensuring minimal disruption to their revenue cycle.
Billed Right’s proactive updates and clear communication kept the client informed at every stage of the process.
You’ve seen the impact in our Credentialing Case Study. Now, it’s time to apply these insights to your practice.
Don’t let billing challenges affect your bottom line. With the right strategies, you can improve reimbursements, reduce administrative burdens, and focus more on patient care.
Fill out our contact form today and let Billed Right help you optimize your revenue cycle with proven solutions.
Looking to Optimize your Revenue Cycle?
"*" indicates required fields
