Credentialing as a Service for Medical Groups
Provider credentialing should not depend on spreadsheets, email chains and someone remembering the next renewal date. Billed Right manages provider enrollment, payer follow-up, CAQH, re-credentialing, license and DEA monitoring, hospital privileges and multi-location credentialing through a dedicated credentialing team supported by purpose-built technology.
Standalone service. No Billed Right RCM contract required.
Credentialing Delays Become Revenue Delays
A provider cannot generate expected in-network revenue until payer enrollment is complete. When applications, follow-ups, renewals or provider records are managed inconsistently, credentialing becomes a revenue problem, not just an administrative problem.
Common Problems Without a Managed Credentialing Model
- A provider starts before payer enrollment is complete
- Application status is unclear
- Payer follow-up is inconsistent
- CAQH is outdated
- Licenses or DEA certificates approach expiration
- Re-credentialing dates are missed
- New locations are not enrolled correctly
- Roster changes are not reflected across payers
- Privileging requirements are tracked separately
- Leadership lacks a single source of status
Credentialing should be managed as an operating system, not a spreadsheet project.
Get Providers Enrolled. Keep Credentials Current.
Billed Right combines experienced credentialing specialists, structured workflows and purpose-built credentialing technology to manage provider enrollment, maintenance, monitoring and re-credentialing from one operating model.
ENROLL → TRACK → FOLLOW UP → MONITOR → RENEW → REPORT
Managed Enrollment. Continuous Monitoring. Clear Visibility.
Managed Enrollment
Provider onboarding, payer applications (Medicare, Medicaid, commercial plans, specialty networks), demographic updates, new locations, group affiliations and roster updates.
Applications submitted within five business days after receipt of a complete provider profile.
Continuous Monitoring
License expiration, DEA expiration, malpractice-policy expiration, CAQH attestation, payer re-credentialing, hospital/facility reappointments, exclusion monitoring and open applications.
Visibility
What is pending, what is approved, what is waiting on the provider, what is waiting on the payer, upcoming renewals, and status by provider, payer and location.
Know what is pending, what is approved, what needs action and what is coming due.
Full-Service Credentialing From Enrollment Through Ongoing Maintenance
New Provider Enrollment
Commercial payers, Medicare, Medicaid, specialty networks and payer-specific enrollment workflows.
CAQH Management
Profile setup, updates, attestation-cycle management and maintenance.
License & DEA Monitoring
Active license tracking, DEA tracking, expiration alerts and renewal workflow support.
Exclusion Monitoring
Technology-assisted checks may include OIG, SAM, state exclusion sources and other supported primary sources.
Re-Credentialing
Upcoming requirement identification, application preparation, submission, tracking and follow-up.
Hospital / Facility Privileging
Initial privileging, facility credentialing, privilege monitoring, reappointments and multi-site privilege management.
Multi-Location Enrollment
Additional locations, group affiliations, payer updates, roster management and site-level status.
Provider Demographic Updates
Address, specialty, tax ID, NPI-related updates where appropriate, group information and payer record changes.
EFT / Banking / Payer Changes
Defined payer change workflows handled as contracted.
Submitting the Application Is Only the Beginning
Credentialing does not end when the application is submitted. Billed Right maintains an active follow-up process so open applications do not sit unattended.
SUBMIT → FOLLOW UP → RESPOND → ESCALATE → APPROVAL → MAINTAIN
Active payer applications are placed on an approximately two-week follow-up cadence until approval or resolution.
Technology Supports
- Task creation
- Reminders
- Application status
- Follow-up documentation
Human Credentialing Specialists
- Contact the payer
- Document status
- Resolve requests and obtain missing information
- Escalate where appropriate
- Keep the workflow moving
One Operating Model From Provider Intake Through Renewal
Intake
Collect complete provider information and documentation.
Verify
Review the profile and required credentialing data.
Apply
Submit payer and facility applications.
Follow Up
Maintain approximately two-week payer follow-up cadence.
Approve
Record approval and effective information.
Monitor
Track expirations, CAQH, payer status, licenses and other requirements.
Renew
Begin re-credentialing and renewal work before deadlines.
Automation Handles the Repetitive Work. Credentialing Specialists Handle the Exceptions.
Credentialing requires technology and judgment. Billed Right uses purpose-built credentialing technology to reduce repetitive administrative work while experienced specialists manage payer requirements, exceptions, follow-up and escalation.
Technology Can Help With
- Secure document collection and storage
- Data extraction and form population
- Expiration reminders and task automation
- Status tracking and primary-source connections
- Audit trail and payer workflow organization
Billed Right Specialists Handle
- Application review and payer-specific requirements
- Incomplete information and payer communication
- Follow-up, exceptions and escalation
- Client communication
- Complex credentialing decisions
AI and automation support the credentialing team. They do not replace credentialing judgment or payer follow-up.
Collect Provider Information Once. Reuse It Across the Workflow.
- Providers upload credentials digitally where applicable through the technology platform
- Data and documents remain organized
- Teams avoid repeated email requests
- Credentialing specialists reuse stored information across enrollment workflows
- Expiration reminders help keep records current
A provider may still be asked for additional payer-specific documentation as individual applications require it.
Keep CAQH Current Without Waiting for a Deadline
Outdated CAQH information can create enrollment delays and unnecessary rework. Billed Right manages profile maintenance and attestation cycles as part of the contracted credentialing scope.
- Profile updates
- Document updates
- Attestation tracking
- Recurring maintenance
Keeping CAQH current reduces avoidable delays, but it does not guarantee payer approval.
Credentialing Beyond Payer Enrollment
- Hospital privilege applications
- Facility credentialing
- Reappointments
- Privilege expirations and supporting documentation
- Multi-facility status tracking
One credentialing operating model across payer enrollment and facility privileging.
Hospitals and facilities retain approval authority.
Credentialing Gets Harder as the Organization Grows
Every added provider, payer, state and location increases the number of credentialing relationships that must stay current. Billed Right gives growing organizations a structured model for managing that complexity.
- Multi-location enrollment
- Multi-state licensure coordination
- Medicare / Medicaid and payer enrollment
- Provider rosters and facility privileges
- Telehealth registrations where applicable
- Site-level reporting and centralized status
PROVIDER × PAYER × LOCATION × STATE = CREDENTIALING COMPLEXITY
CaaS creates one operating model across that complexity.
A Credentialing Model Built for Growth and Add-On Integration
For PE-backed healthcare groups, multi-specialty platforms, rapidly growing private practices, multi-state groups, MSOs and large provider organizations.
Centralized Operations
Centralized credentialing, onboarding newly acquired practices and common workflows.
Consistent Tracking
Consistent tracking, roster management and executive reporting across the organization.
Dedicated Resources
Dedicated credentialing resources and custom operating requirements.
Every Enterprise engagement is scoped individually. SLA and technology integration are not identical across every engagement.
Working Within Your Existing Systems
Integration capabilities are expanding across EHR, PM and other provider-management systems through our credentialing technology platform. Availability depends on the client environment, system capabilities and integration requirements.
For Enterprise organizations, custom integration options can be evaluated during implementation.
Scope Levels, Not Price Tags
Pricing is customized based on provider count, locations, payer complexity, service scope and support model.
Managed Credentialing
Best for established medical groups needing reliable enrollment and ongoing maintenance.
- Provider enrollment
- CAQH management
- Payer tracking
- License / DEA monitoring
- Exclusion monitoring
- Re-credentialing
- Recurring reporting
Growth & Multi-Location CaaS
Best for practices adding providers, locations and complexity.
- Everything in Managed Credentialing
- Demographic updates
- Payer change requests
- Multi-location enrollment
- Roster management
- Hospital privileges
- Location-level visibility & executive reporting
Enterprise CaaS
Best for large groups, PE-backed platforms, health systems and multi-state organizations.
- Custom SLA
- Multi-state management
- Facility privileging
- Dedicated credentialing resources
- Enterprise reporting
- Onboarding program management
- Custom workflow & integration evaluation
Credentialing Data Requires Healthcare-Grade Security
Our credentialing technology platform, Credential Network, is SOC 2 Type II certified and HIPAA compliant, with encryption, MFA and audit logging built into the platform.
Credential Network is a third-party credentialing technology platform used by Billed Right to deliver this service. Billed Right itself is not SOC 2 certified; the certification described above belongs to the Credential Network platform.
Why Use Billed Right Instead of Managing Credentialing Internally?
Dedicated Credentialing Specialists
People who work the process every day.
Structured Follow-Up
Applications are actively tracked and followed up.
Technology-Enabled Workflow
Reduce spreadsheets, email chains and manual reminder systems.
Ongoing Maintenance
Credentialing is managed after initial approval.
Visibility
Know application and renewal status.
Scale
Support providers, payers, locations and states through one operating model.
Standalone Service
No Billed Right RCM contract required.
You do not have to build the credentialing infrastructure internally to have a disciplined credentialing operation.
A Real Credentialing Engagement, Still Underway
A Central Florida Sleep Medicine practice, one physician and three nurse practitioners, engaged Billed Right to manage credentialing across more than 20 payers. The engagement remains active.
Results reflect the engagement at the published mid-project point and should not be interpreted as guaranteed outcomes.
More on Credentialing
How Provider Credentialing Impacts Revenue Optimization
Why enrollment status is a direct driver of billable revenue, not just an administrative step.
ReadWhat Is Credentialing and Why Is It Important?
A foundational look at payer credentialing and why it matters for practice revenue.
ReadUnderstanding Credentialing Chaos
Where credentialing tends to break down without a structured operating model.
ReadCredentialing as a Service FAQs
Credentialing as a Service is Billed Right's managed provider-enrollment and credential-maintenance service.
No. CaaS is available as a standalone service.
Billed Right targets submission within five business days after receiving a complete provider profile and all required information. Payer approval timing varies.
Active applications are generally placed on an approximately two-week follow-up cadence until approval or resolution.
Yes. CAQH profile setup, maintenance and attestation management can be included.
Yes. Ongoing monitoring and expiration workflows can be included.
Yes.
Yes. Hospital/facility privileging and reappointment management can be included.
Yes.
Yes, based on scope.
Billed Right uses Credential Network as part of its credentialing technology stack.
Credential Network publicly states that its platform is SOC 2 Type II certified and HIPAA compliant.
The credentialing technology includes AI-assisted capabilities such as document parsing, data extraction and workflow assistance. Billed Right specialists remain responsible for managed-service execution.
Integration options can be evaluated based on the client's EHR, PM, HR or provider-management environment.
Pricing is based on provider volume, locations, payer complexity, service scope and support requirements. Billed Right provides a customized proposal.
Ready to Build a More Reliable Credentialing Operation?
Whether you are adding providers, expanding locations, managing payer renewals or trying to replace a spreadsheet-driven credentialing process, Billed Right can help build a managed credentialing workflow that keeps applications moving and leadership informed.
Schedule an Executive Conversation
Prefer to talk now? Call 407-217-9281 and ask for a Credentialing Specialist
Standalone service. Built for growing medical groups.