Medical billing services · credentialing · revenue cycle Every claim, worked until it's paid.

CredSpun LLC runs the whole revenue cycle for outpatient practices — and the credentialing that has to happen before any of it can be billed.

  1. 1.Enrolled and dated before you bill
  2. 2.Denials worked daily, root causes monthly
  3. 3.Month to month, in your own software
Clean claim rate
95%first pass
Days in AR
Claim · 88214Aetna Better Health · 99214 office visit
$269.75
EligibilityCleared
Prior authorizationCleared
RegistrationCleared
Medical codingCleared
Charge entryCleared
Payment postingCleared
Denial managementCleared
AR follow-upCleared
Submitted 22 Jul · paid in 12 daysPaid · first pass
ERA posted automatically

The targets we work every account toward

95%+

Clean claim rate

Under 90% signals a front-end problem.

<40

Days in AR

Past 50, cash sits in unworked claims.

<5%

Denial rate

Higher means the same mistakes keep repeating.

96%+

Net collection rate

Of what contracts entitle you to, not what you charged.

U.S.-registered LLCBAA signed before accessWorks in your EHRMonth to monthNamed account leadDenials worked dailyClearinghouse-agnosticReply within one business day

The revenue cycle, end to end

Eight stages.Revenue leaks at the handoffs between them.

Every denial gets blamed on the stage before it. We take the whole loop.

Denial causes fed back upstream

A denial in stage 07 is usually a mistake made in stage 01.

Services

The work that decides whether billing can succeed at all.

Claims fail for reasons outside the claim. We cover those too.

Credentialing

Through to a countersigned contract and a confirmed effective date.

What's included

  • CAQH build and re-attestation
  • PECOS / Medicare enrollment
  • State Medicaid and managed care
  • BCBS, Aetna, Cigna, UHC panels
  • Group linkage, Tax ID, locations
  • Licence, DEA, malpractice tracking

Clearinghouse & EDI setup

The plumbing a claim travels through. Unglamorous and frequently skipped.

What's included

  • EDI enrollment for electronic claims
  • ERA enrollment for remittance
  • EFT setup for direct deposit
  • Payer portal access
  • Clearinghouse configuration and testing

Patient billing support

A patient who doesn't understand a statement doesn't pay it.

What's included

  • Statement cycles and balance notices
  • Inbound patient billing calls
  • Payment plan setup and monitoring
  • Cost and coverage questions
  • Follow-up before a write-off

Front office & scheduling

A named person on your phone and calendar. Not a shared queue.

What's included

  • Scheduling and confirmations
  • Inbound calls, triaged to clinical staff
  • Referral intake and coordination
  • Waitlist and no-show recovery
  • Records requests and patient forms

Reporting you can act on

Monthly, by provider, location and payer — the measures that predict cash.

What's included

  • Clean claim rate, first-pass resolution
  • Days in AR and aging past 90
  • Denial rate and top reasons by payer
  • Net collection against contracted rates
  • Charge lag and unbilled encounters

Account management

Commitments most vendors still won't make in writing.

What's included

  • A named account lead, not a pool
  • Scheduled fortnightly status call
  • Written status on every open application
  • Direct line to the person on your claims
  • Hours overlapping your business day

Credentialing & payer enrollment

You cannot bill a payer you aren't enrolled with.

Claims dated before your effective date get denied on timing alone, however clean they are.

Typical enrollment

≈150 days start to effective date

Three weeks are ours. The rest is payer time — we follow up every 7–14 days.

Ours to controlDay 0–21 · 21 days14%
Payer timeDay 21–135 · 114 days76%
Contract & effective dateDay 135–150 · 15 days10%
Day 0–18Documents & CAQH buildWe control this part
Day 8–26Primary source verificationRuns alongside
Day 21–83Medicare · PECOSPayer timeline
Day 21–123Commercial payersEach on its own clock
Day 90–150Contract & effective dateIn writing before you bill
  1. 01

    CAQH profile audit

    Audited for gaps, or built from scratch.

  2. 02

    Document collection

    One encrypted file: licence, DEA, malpractice, W-9, CV.

  3. 03

    File tracking

    Every application has an owner and a status.

  4. 04

    Application submission

    All payers at once — sequencing costs you months.

  5. 05

    Follow-up

    Contact every 7–14 days until a decision lands.

  6. 06

    Contract execution

    Effective date in writing before you bill.

Specialties

Payer rules differ by specialty. So does the workflow.

Six of the specialties we work in, each with its own denial pattern.

Systems

We work in your software, not ours.

We don't sell an EHR, so we have no reason to move you onto one.

  • EHRathenahealth
  • EHReClinicalWorks
  • PMTebra / Kareo
  • PMAdvancedMD
  • EHRSimplePractice
  • EHRDrChrono
  • EHRTherapyNotes
  • EHRPractice Fusion
  • PMOffice Ally
  • PMOpen Dental

Clearinghouse-agnostic. If your platform isn't listed, ask — this is what we see most, not a limit.

What we are

A team that does the work — not a platform you have to run.

Software still assumes somebody on your side works the denial queue. If you had that person spare, you wouldn't be reading this.

Buying a platformWorking with CredSpun
SetupImplementation, then staff trainingWe use the system you have
CostLicence fees either wayA share of what we collect
Payer callsYour team still makes themWe call and write the appeals
DenialsWait for someone's free timeWorked daily, root causes monthly
SupportA ticket when something breaksA named person who knows you

Onboarding

Switching billing companies without a cash gap.

The risk isn't the new claims — it's the AR your old vendor stops working.

Before cutoverDiscovery and a written plan
CutoverNew claims move to us
Weeks 4–6First honest signal
Day 90A full cycle to judge us on

Who you're actually hiring

A Denver company with a dedicated operations team.

You are about to hand a partner your NPI, your patient roster and your remittance data. We say plainly who is on the other end.

CredSpun LLC is a U.S. company based in Denver, Colorado. The day-to-day billing and credentialing work is done by a dedicated operations team outside the U.S. — under a BAA signed before any access, and the six data rules below.

EntityU.S.-registered LLC
OfficeDenver, Colorado
ComplianceHIPAA-aligned, BAA first
CommitmentMonth to month
A clinician talking with a patient during an outpatient visit — the practice CredSpun bills for
The clinician stays the practice. We stay the paperwork.

How your patient data is handled

Six rules, applied on every account.

HIPAA-aligned
BAA firstSigned before any access is granted.
Scoped accessCredentialing staff never see remittance data.
EncryptedTransmission and storage of every document.
Named loginsUser access logged to a person, not a team.
Revoked on exitAccess ends the day an engagement does.
Never reusedYour data is not sold, shared or reused.

Questions

What practices ask on the first call.

How is your pricing structured?

Billing is priced as a percentage of what we collect, credentialing is priced per application, and front-office coverage is billed monthly. We quote after seeing your numbers rather than from a rate card, because the right percentage depends on your specialty, payer mix, claim volume and how much legacy AR needs working. To get a quote, send an aging summary and your recent denial reasons; the free practice review that follows shows clean claim rate, denials by payer, aging and suspected underpayments, and the quote is based on what it finds. We work inside the software you already use, terms are month to month with 30 days' notice, and your data leaves with you at no exit charge. Because billing is a share of collections, we are paid more only when you are.

Do I have to switch EHR or practice management software?

No. We work in your system and the licence stays in your name.

How long does credentialing take?

Typical enrollment takes about 150 days — roughly five months — from a complete document file to a confirmed effective date. About three weeks of that is ours to control: auditing or building the CAQH profile, collecting your licence, DEA, malpractice, W-9 and CV, and submitting every application at once. The rest is payer time. Medicare through PECOS commonly decides first; each commercial payer and Medicaid plan runs on its own clock, and contract execution with a confirmed effective date usually lands between day 135 and day 150. Some panels finish sooner, and a few take longer. Start at least four to five months before you need to bill, and send documents early — nothing begins until they are in hand, and claims dated before your effective date are usually unrecoverable.

Can I see patients before credentialing is finished?

You can, but it is risky: claims for visits before your effective date with a payer are usually denied and are rarely recoverable, however clean they are. Some practices see those patients as self-pay until enrollment completes. Some payer contracts allow a new provider to bill under a supervising or already-enrolled provider for a limited period, and Medicare allows limited retroactive billing once enrollment is approved — but the rules differ by payer, state and arrangement, and getting them wrong can create repayment problems later. We read the contracts and enrollment terms you actually have and tell you in writing what yours permit, then confirm each effective date before the first claim to that payer goes out.

Can you work the AR my last billing company left behind?

Yes — as a distinct, defined project, separate from your new claims. When a practice switches billing companies, the biggest risk is not the new claims; it is the AR the old vendor stops working. We pull the open balances, then rank each claim by its odds of recovery, how close it is to the payer's timely filing deadline, its balance and whether a fixable upstream problem is blocking it. Claims close to their filing limit are worked first. We tell you in writing which balances are worth pursuing and which to write off, rather than chasing them forever, and aging past 90 days is reported monthly by payer so you can watch it shrink.

Who actually works on my account?

Named leads, not a rotating pool, on hours that overlap your day.

How is patient data protected with a team outside the U.S.?

CredSpun LLC is a U.S. company based in Denver, Colorado, and our day-to-day operations team works outside the U.S. Every account runs under the same rules. A Business Associate Agreement is signed before anyone is given access. Access is scoped to the task, so credentialing staff never see remittance data. Documents are encrypted in transmission and storage. Every login belongs to a named person, so activity is logged to an individual rather than a shared team account. Access is revoked the day an engagement ends, and your data is never sold, shared or reused. We work inside your own EHR and practice management system, so patient records stay in software you control rather than being copied into ours.

Are we locked into a contract?

Month to month with 30 days' notice, and your data leaves with you at no exit charge.

What happens in the practice review?

The review is free, and the findings are yours in writing whether or not you work with us. Send an aging summary and your recent denial reasons, and we look at five things: your clean claim rate and first-pass resolution, denial reasons broken down by payer, AR aging including balances past 90 days, suspected underpayments against your contracted rates, and payer panels you are not enrolled with. Each finding comes with its likely cause and what it is worth, including the problems you can fix without us. If working together makes sense, the review is also what our quote is based on. We reply within one business day.

Book a call

Book a call with our CEO.

Pick a time that suits you. We'll walk through your claims, denials and payer enrollment, and tell you what we'd fix first.

Tell us where the money is stuck.

Send your aging summary and denial reasons. You get the findings in writing, including what you can fix without us.