Medical billing and credentialing questions, answered.

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.

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

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.

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.

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.

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

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.

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

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.

athenahealth, eClinicalWorks, Tebra / Kareo, AdvancedMD, SimplePractice, DrChrono, TherapyNotes, Practice Fusion, Office Ally and Open Dental most often. That list is what we see most, not a limit — if yours isn't on it, ask.

No. We are clearinghouse-agnostic, and we set up EDI, ERA and EFT enrollment with whichever one you use.

Within one business day, from the named person on your account.

Clean claim rate and first-pass resolution, days in AR and aging past 90, denial rate with the top reasons by payer, net collection against contracted rates, and charge lag with unbilled encounters — by provider, location and payer.

Payments are posted line by line against your fee schedule. An underpayment is flagged and pursued, not quietly written off.

First-pass acceptance in weeks four to six shows whether the front end is fixed. By day 90 you have a full cycle of net collection, days in AR and denial rate to judge us on.

CredSpun LLC is based at 1500 N Grant St, Ste R, Denver, CO 80203, and works with outpatient practices across the United States. Our dedicated operations team works outside the U.S. under a BAA.

Yes. For a new practice, credentialing comes first — you cannot bill a payer you are not enrolled with — so we start with the CAQH profile and payer applications, then set up EDI, ERA and EFT with each payer so the first claim can go out electronically. You don't need an aging report to start; tell us your opening date and the payers you want to be in-network with.