ASP-RCM Credentialing. As a product, not a paperwork queue.
Initial enrollment, re-credentialing, and payer contract negotiation, run on ASP-RCM Credential OS, our 17-module platform with NCQA audit-ready packets, AI document extraction, and a continuously verified primary source. Senior partner accountable end-to-end.
Most RCM vendors treat enrollment as back-office paperwork. We treat it like a real product.
Every day a clinician sits idle waiting for payer enrollment is a day of clinical revenue thrown away. Most organizations lose $200K-$800K per provider per cycle to credentialing drag they don’t measure. We made it the front of the operating system.
Three written engagements
Each one has a written SLA, a senior partner, and a clear shape, not a vague “we’ll handle it.”
Credential OS, ours, included
17-module operations platform, admin, coordinator, and provider portals.
NCQA audit-ready, by default
Pre-built audit packets. Not assembled the week of the audit.
Continuously verified PSV
Primary-source verification refreshed continuously, not at re-cred time.
Three ways we work. Pick the one that fits.
Each one comes with a written SLA and a senior partner who owns it. We don’t publish rates here because no two credentialing footprints look alike, specialty mix, payer mix, state count, and hire pace all change the math. A 30-minute scoping call gives us what we need to write the proposal.
Initial Provider Enrollment
For groups hiring net-new clinicians or expanding into new states. CAQH-to-effective-date in a fraction of the legacy cycle.
- Pre-flight document pack built before the offer letter is signed
- Parallel payer enrollment, 8 payers worked simultaneously, named owner each
- Daily aging sweep with 24-hour escalation triggers
- Effective-date hunting where retroactive dates are contractually allowed
- Commercial, Medicare Part B, Medicaid, Tricare, hospital-based
Re-credentialing & Revalidation
The silent revenue killer. Drop one payer revalidation deadline and your clinician’s claims start denying retroactively. Continuous monitoring solves it.
- Continuous primary-source verification. License, DEA, NPDB, OIG, SAM, board cert
- CAQH ProView management. Quarterly attestation, profile hygiene
- Revalidation calendar with payer-specific lead-time alerts (90/60/30/7)
- Hospital privileging cycles on parallel timeline
- Revenue-at-risk dashboard. Dollar exposure of expiring credentials
Payer Contract Negotiation
Most groups have not modeled their commercial contracts against actual remittance data in three years. The gap, on average, is 4-9% of net revenue.
- Contract-vs-actual analysis across 24 months of EOBs
- Underpayment recovery on contracted-rate variance
- Fee schedule modeling against regional benchmarks
- Re-negotiation playbook. Data package + payer rep relationship map
- Single-case agreements for out-of-network care, where indicated
Credential OS. Our 17-module credentialing operations workspace.
It isn’t a vendor portal or a Salesforce add-on. It’s a system we built ourselves with three role surfaces, Admin, Coordinator, Provider Portal, that every account uses, included with the engagement.
Seventeen modules. Three role surfaces.
Admin and Coordinator workspaces handle 14-17 modules each; the Provider Portal exposes the seven that providers actually need. Same data underneath, different view on top.
Dashboard
KPIs, expirations heat-map, payer pipeline, recent activity.
Team
All providers, status filters, compliance bars.
Tracking
5-column kanban, Documents Needed → Approved, with Pre-Flight v4 swimlane.
Documents
Categorized repository: license, insurance, education, ID, CV.
AI Document Queue
LLM-extracted fields with per-field confidence scoring. Auto-approves above threshold; routes the rest.
Live Monitoring
Continuous primary-source verification. License, DEA, NPDB, OIG, SAM.
Revenue at Risk
Dollar exposure of expiring credentials. Per provider, per payer, per day.
Verification Network
Cross-tenant PSV reuse. A verified license verifies once, savings ledger tracks the spend avoided.
Provider Messaging
WhatsApp/SMS bot inbox. Providers attach documents from their phone.
NCQA Audit Files
Pre-built audit packets. The week of the audit is not the week we start assembling.
AI Agent Access
MCP token management. Lets your downstream systems read credentialing state directly.
Forms Library
CAQH ProView, Medicare Part B, BCBS, Aetna, TX Medical Board, DEA Form 224, mapped, not filled by hand.
Reports
6 templates + 6-month compliance trend charting.
Alerts
Active expirations with one-click resolve and audit-trail reason codes.
Users & Roles
Workspace access control. Admin/Coordinator/Provider role gates.
Integrations
CAQH, NPDB, state boards, payer APIs, EHR/PM systems.
Plus M17, Settings, org profile, branding, tenant config.
The six moves. The same playbook that hit 22 days.
This is how the team actually runs the work, day to day. Same six moves whether you’re a 12-clinician ABA group or a 400-provider hospital system. The shapes change; the moves don’t.
Pre-flight document pack
Document collection starts before offer-letter signature. Day-one CAQH-ready. Owned by HR, lives in the offer packet, not credentialing.
Parallel payer enrollment
8 payers per state worked simultaneously by named owners. Not a queue. Each payer has its own aging trigger and escalation path.
Daily aging sweep
Every active file aged against payer-specific SLAs. Anything outlier escalated within 24 hours. 10-minute morning ritual on the operations team.
Payer relationship map
Provider-rep contacts per payer. First-name basis on escalations. Documented, not tribal. Survives team rotation.
Effective-date hunting
Retroactive effective dates pursued where contractually allowed. The difference between losing 90 days of revenue and losing 10.
Onboarding sync
Clinical onboarding aligned to credentialing milestones, not start dates. New hires don’t sit idle waiting for payer approval.
Outcomes, measurable.
Different specialties play by different payer rules.
Credentialing isn’t a single workflow. Hospital privileging, BCBA enrollment, behavioral health parity, and physician-group multi-payer management each have their own playbook. The team you work with knows yours.
Behavior Analyst enrollment.
BCBA, BCaBA, RBT enrollment across commercial, Medicaid, and Tricare with state-specific rules. CASP-affiliated; we know the difference between the BACB requirement and the payer requirement.
Privileging & payer alignment.
Initial appointment, biennial reappointment, FPPE/OPPE-aligned, with payer enrollment running on a parallel timeline so privileging doesn’t become the bottleneck for billing.
Multi-payer, multi-location.
Group NPI + individual NPI alignment, IPA & ACO roster management, and contract-cycle modeling. The specialty where re-credentialing is where revenue silently dies.
Parity-aware enrollment.
LCSW, LMFT, LPC, LMHC, prescriber alignment with payer behavioral-health roster mechanics. Parity Act violation appeals workflow built into the credentialing layer.
Plugged into the systems that matter.
Credential OS reads from the source systems continuously, so your data doesn’t get re-keyed at re-cred time, it’s already there.
What is a 48-day credentialing delay per clinician costing you?
The math is the same model we use in scoping calls. Every day a clinician sits idle waiting for payer approval is fully-loaded clinical revenue thrown away, minus the carrying cost of salary, which still runs.
Default 48 days reflects the 110→62 day compression measured in the multi-state ABA case study.
Clinical revenue recovered from compressing your credentialing cycle:
A 30-minute scoping call. No NDA needed for the first conversation.
Built for the audit, not for the demo.
Credentialing is the most audit-heavy part of the revenue cycle. Credential OS treats audit-readiness as something you live in, not something you cram for.
Audit packets, daily-ready.
Pre-built file packets for any provider, any payer, any window. Not assembled the week of.
Tenant-isolated PHI.
BAA in place. Access logged at the field level. AES-256 at rest, TLS 1.3 in transit.
Type II controls.
Continuous controls monitoring. Annual external attestation across security, availability, confidentiality.
Information security.
ISMS aligned to ISO 27001. Vendor risk reviewed annually for every connected source.
Credentialing, at operating scale.
What the credentialing operation has carried across active accounts and prior engagements. Continuous PSV runs every business day; revalidations don’t miss.
Figures reflect ASP-RCM credentialing operations including affiliated CASP-credentialed work. Tenant-specific numbers available under NDA.
Two very different teams. Same way of working.
Both ran on the same six moves and the same operating system. What changed was the buyer, an ABA group hiring fast, and a hospital running privileging cycles.
110 → 62 day cycle.
A 3-state ABA network onboarded 40 clinicians in 12 months without credentialing becoming the hire-pace bottleneck. BCBA enrollment averaged 22 days across 6 commercial payers in parallel.
Audit defended. Zero findings.
A community health system inherited a credentialing operation with three years of inconsistent file hygiene. Walked into an NCQA cycle six months later with audit-ready packets pre-built and zero file findings.
The folks who audit credentialing know who we are.
Membership and registered-vendor status across the organizations that set credentialing, billing, and compliance standards in U.S. healthcare.
Hiring fast? Don’t lose 90 days per clinician.
A senior partner audits your current credentialing cycle, identifies the three workflow breaks, and writes a 90-day compression plan. Same playbook that hit 62 days. No software pitch.