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HMT Billing Solutions

Services

You Cannot Bill a Payer You Are Not Enrolled With

Credentialing is the least visible part of the revenue cycle and one of the most expensive to get wrong. A provider who starts seeing patients before enrolment completes generates claims that cannot be billed, and revalidation deadlines arrive without warning.

The cost of a credentialing delay is not the paperwork. It is the revenue that does not exist while a new provider sees patients under an application that has not been approved. Depending on the payer, that window can run for months, and the encounters inside it are frequently unbillable rather than merely delayed.

The failure modes are mundane and consistent: an application submitted with an inconsistency the payer will not query but will park, a CAQH attestation that lapsed, a revalidation notice sent to an address nobody checks, a group roster that was never updated after someone left. None of these are difficult problems. They are tracking problems, and they are what tracking systems exist for.

We handle initial credentialing and enrolment, keep CAQH profiles attested and current, monitor revalidation and expiry dates before they become urgent, and maintain the payer roster as providers join and leave. Contracting is the natural extension. Once you know which payers you are with and what you are being paid, the question of whether those terms are worth renegotiating becomes answerable.

Credentialing & Contracting

Services in This Group

Sold individually or bundled. Most engagements combine two or three.

  • Provider Credentialing

    Initial credentialing, CAQH maintenance and revalidation tracking, so enrolment never lapses unnoticed.

    Explore Provider Credentialing

  • Payer Enrollment & Revalidation

    Enrolment, revalidation and participation maintenance across commercial and government payers.

  • Payer Contracting

    Contracting support to improve the terms you are enrolled under, once you can see what you are actually paid.

FAQ

Questions We Get Asked

How long does credentialing take?

It varies by payer and by state, and it is largely outside anyone's control once an application is complete and submitted. What is controllable is whether the application goes in complete and correct the first time, and whether it is followed up on a schedule rather than when someone remembers. Those two things are the difference between the normal range and the horror stories.

Can you take over credentialing for providers we already have enrolled?

Yes, and this is the common case. We audit the current state first, which payers each provider is enrolled with, which enrolments are active, what is approaching revalidation, and whether CAQH is current. That audit usually surfaces at least one thing nobody knew about, and it is the base for everything afterwards.

Do you handle contracting as well as enrolment?

Yes, as a separate service line. Enrolment gets you in the door with a payer on their standard terms. Contracting is the conversation about what those terms should be, which requires knowing your actual payer mix and reimbursement patterns. It is worth doing after billing has been running long enough to produce that picture.

Related

Other Services We Offer

Or take it as one engagement: End-to-End Revenue Cycle Management, ER Billing Services, Urgent Care & Clinic Billing and Hospital & Facility Billing.

Start With a Free Revenue Cycle Audit

We review a sample of your recent claims and your current A/R aging, and report where revenue is being lost. The report is yours whether or not you engage us.

Request your free auditor call +1 307-443-6998