Credentialing and enrollment specialists dedicated to your organization, working your payer portals and your CAQH profiles, employed by Connext in-country.
Quick answer
Verifying a provider's licences, training and work history at the source, then filing with each payer and staying on it until that provider can be billed for.
Until a provider is credentialed and enrolled, everything they do is unbillable.
Credentialing is the verification: licences, DEA registration, medical school, residency, work history, references and malpractice coverage, checked with the source that issued them. It is a clinical background check, only longer and with more riding on it. A credentialing team is the people who collect all of that, chase the verifiers who are slow to answer, keep the CAQH profile current and file with each payer in the format that payer wants. Every week they save is a week the provider can see patients and be paid for it.
Connext Credentialing Teams are dedicated specialists who do this all day, inside your system and your payer portals. You hire the provider. They make the provider billable.
Roles scoped in 48 hours and screened against the payers you work with and the portals you file in. You interview the shortlist and you choose. Average time to hire is 21 days.
Connext is the legal employer: contracts, payroll, benefits, local compliance, equipment and secure facilities. You direct the work without opening an entity abroad.
Your credentialing software and your payer portals stay the system of record, with role-based access. Provider data never leaves your environment, under signed BAAs and SOC 2 Type II controls.
Weekly reviews on what is open and what is aging, QA on every file before it goes out, and retention management that keeps annual attrition near 20% against a 50% industry standard.
STEP 01
Verifies licences, DEA registration, education, residency, work history and malpractice coverage with the body that issued them, not from the copy the provider sent over.
STEP 02
Builds each payer application in the format that payer requires and files it, instead of finding out about a formatting rejection three weeks later.
STEP 03
Keeps the CAQH profile complete and attested, which is what most payers read before they read anything else you send them.
STEP 04
Chases the licensing boards, the references and the payer queues that decide how long this takes. The least glamorous part, and the one that moves the date.
STEP 05
Tracks licences, certifications and re-credentialing dates before they lapse, so a provider never drops out of network over a renewal nobody was watching.
When credentialing keeps pace, a new provider starts billing on schedule. When it does not, you are paying a salary against revenue you cannot invoice.
A provider who is hired but not yet enrolled still draws a salary, still occupies a room and still cannot be billed for. Every week of delay is that cost with nothing on the other side of it. Smaller practices feel it hardest: the work is dozens of documents across several portals under rules that keep changing, and it usually lands on an administrator who already has another job. AAPPR and MGMA have both put numbers on what those delays cost in lost earnings and disrupted care.
No, and the difference is where most of the delay hides. One verifies the provider. The other registers them to be paid.
First
Licences, training, work history and malpractice, checked at the source. It answers whether this provider is qualified and safe to practise.
Then
Registering the provider with Medicare, Medicaid and each commercial payer so claims can be submitted against their name.
Credentialing comes first. Without it there is no enrollment, and without enrollment there is no reimbursement. The revenue is blocked at the start, not at the claim.
Credentialing stalls on a verifier who does not answer. Enrollment stalls on a form that did not match that payer's rules. The same person rarely watches both, which is how weeks disappear between them.
At the point where the queue stops moving. You do not have to hand over the whole function to start.
When you are onboarding several providers at once and the bottleneck is the paperwork, not the recruiting. This is where most engagements start.
Re-credentialing dates and licence renewals, which are invisible until the day a provider falls out of network and the claims start bouncing.
In most practices credentialing is one line in somebody else's job description. A dedicated seat takes it off that plate without adding to your headcount.
So the handover between the two does not add weeks on its own. One team, one timeline, one person you ask for the status.
Your provider and your organization.
Connext assembles and verifies; the signature and the responsibility behind it are yours.
You do.
We file where you tell us to file, in the order you want them filed.
You do.
The team works inside your contracts and escalates to you rather than negotiating anything on your behalf.
You do.
It stays in your system, under signed Business Associate Agreements and SOC 2 Type II controls, and is never stored offshore.
