Medxcode medical billing and coding

Multi-specialty group opens a new location with zero billing delay

Nine providers, one new location, eleven payers — and a hard opening date that could not move.

Multi-SpecialtyGeorgia
9
Providers credentialed
11
Payers enrolled
0
Weeks of billing delay
$486K
Revenue protected

The situation

Previous expansions had lost six to ten weeks of billable revenue per provider while enrollment caught up.

CAQH profiles were incomplete and several licenses were close to expiry.

What we did

  1. 01

    Credentialing started 120 days before the opening date, with a per-payer tracker and weekly follow-up.

  2. 02

    CAQH profiles were rebuilt and attested; expirables were renewed before applications were filed.

  3. 03

    Claims were held and released in effective-date order, capturing every retro-eligible window.

The result

  • — All nine providers held confirmed effective dates before the opening date.
  • — An estimated $486K in revenue was protected versus their previous expansion.
  • — No claims were lost to retro-billing windows.

"For the first time, opening a location was a clinical event rather than a financial hole."

CEO, multi-specialty group

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