Medxcode medical billing and coding

Credentialed on time, so billing never stalls

Payer enrollment, CAQH and PECOS management, re-credentialing and expirable tracking — handled from application to first paid claim.

Get a free analysis (239) 748-0627
60–90 days
Typical enrollment window
100%
Expirable tracking coverage
50 states
Payer coverage
Zero
Missed re-credentialing deadlines
Medical billing specialist collaborating with a clinician

Talk to a provider credentialing specialist

Send us your numbers. You get a written analysis of what is recoverable, within one business day.

HIPAA-aware handling. We never share your details. No contracts to sign to talk to us.

A provider who is not credentialed is a provider who cannot bill. Every week of enrollment delay is a week of clinical capacity you are paying for and cannot invoice — and retro-billing is only available when the payer allows it, which many do not.

Medxcode manages credentialing as a deadline-driven project with a named owner, a tracked application status for every payer, and escalation when a payer stalls.

Credentialing services we manage

We handle new provider enrollment, group additions, location additions, and the ongoing maintenance work that quietly causes claim denials when it slips.

  • Primary source verification and document collection
  • CAQH ProView profile creation, attestation and re-attestation
  • Medicare enrollment and revalidation through PECOS
  • Medicaid enrollment in all states, including managed Medicaid plans
  • Commercial payer applications and contract follow-up
  • Group / TIN linkage and location additions
  • Hospital privileging application support
  • Re-credentialing calendar and expirable tracking (license, DEA, malpractice, board)
  • Payer roster audits so directory data matches your claims data

Why credentialing fails, and how we prevent it

Applications rarely get rejected for lack of qualification. They stall for missing documents, mismatched addresses, unattested CAQH profiles and unanswered payer requests. Our workflow assumes all four will happen and builds follow-up around them.

  • Every application has an owner and a next-touch date
  • CAQH re-attestation reminders every 120 days
  • Weekly payer status calls until an effective date is issued
  • Effective dates confirmed in writing before billing starts
  • Retro-billing windows identified and claimed where permitted

Credentialing and revenue are the same project

Because we also run billing, we know exactly which claims are waiting on an effective date. As soon as a payer approves, held claims are released in the correct sequence — which is where practices most often lose retro-eligible revenue.

How it works

Onboarding that does not interrupt your clinic

  1. 01

    Document intake

    One structured collection of licenses, DEA, malpractice, education, work history and W-9 data.

  2. 02

    Profile and applications

    CAQH built and attested, PECOS and payer applications submitted with a tracked payer list.

  3. 03

    Follow-up until effective

    Weekly payer follow-up and escalation until every effective date is confirmed in writing.

  4. 04

    Maintain

    Re-attestation, revalidation and expirable tracking so nothing lapses.

Packages

Provider Credentialing packages built around volume, not lock-in

Managed service fees start at 3.99% of monthly collections. Specialized projects receive a written custom scope based on volume, complexity and the work required.

Single Provider

Custom scope

based on provider and payer count

Adding one provider to a handful of payers

  • Document collection and verification
  • CAQH profile setup and attestation
  • Application submission and follow-up
  • Effective date confirmation
  • Month-to-month. No setup fee. No long-term lock-in.
Most chosen

Practice Credentialing

Custom scope

based on provider and payer count

New providers or practices entering a full payer panel

  • Unlimited commercial payer applications
  • Medicare and Medicaid enrollment
  • CAQH and PECOS management
  • Group / TIN and location linkage
  • Weekly status reporting
  • Held-claim release coordination

Credentialing Maintenance

Custom scope

based on provider count

Groups keeping panels and expirables current

  • Re-credentialing calendar management
  • CAQH re-attestation every cycle
  • Medicare revalidation handling
  • License, DEA and malpractice tracking
  • Payer roster and directory audits
  • Quarterly credentialing compliance report

Calculator

See the numbers before you talk to us

Credentialing delay cost calculator

Every week a provider waits on enrollment has a price. Here is yours.

3

New providers or providers adding payers.

$14,000

Average billable revenue a provider generates weekly.

8

Weeks of delay you expect without dedicated credentialing management.

Revenue protected by on-time credentialing

$336,000

Revenue at risk from enrollment delays — most of it preventable

Providers enrolling
3
Delay per provider
8 weeks
Revenue protected by on-time credentialing
$285,600

Estimates use benchmark recovery rates from comparable US practices. Your written analysis replaces these estimates with numbers from your own payer mix.

Want this modelled on your real data?

Send the form your figures and we will rebuild this estimate from your payer mix, fee schedule and current aging — free, in writing, with no obligation.

  • Written analysis within one business day
  • Line-item view of recoverable revenue
  • Root-cause list for your top denials
  • No contracts required to receive it
Try the full custom cost calculator →

Send me this analysis

We will use the figures you moved above as a starting point.

HIPAA-aware handling. We never share your details. No contracts to sign to talk to us.

Proof

Provider Credentialing results from real practices

$0

Revenue lost to enrollment delay

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

Multi-Specialty · Georgia

$428K

Delayed revenue recovered

Gastroenterology group recovers $428K in delayed infusion revenue

Gastroenterology · California

FAQ

Provider Credentialing questions we get every week

How long does credentialing take?
Commercial payers typically take 60 to 90 days, Medicare 45 to 60, and Medicaid varies widely by state. We start the clock immediately and report weekly.
Can we bill for services provided before the effective date?
Sometimes. Certain payers allow retroactive billing to the application or effective date. We identify those windows and release held claims accordingly.
Do you manage re-credentialing?
Yes, with a tracked calendar for re-attestation, revalidation, licenses, DEA and malpractice coverage. Missed deadlines are the most avoidable cause of claim denials.

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