Credentialing in California
Soft Home Global provides payer enrollment, revalidation and follow-up for California practices and billing companies at $2,450 per seat per month. Full time, worked during California business hours, inside your own system.
What is specific to California
Medi-Cal claims run through a separate submission path from commercial payers, and the timely filing window is shorter than most practices assume.
California’s Medicaid programme is Medi-Cal. Practices with a meaningful Medi-Cal mix usually need it worked as its own queue rather than mixed into commercial follow-up, because the submission path, the timely filing window and the appeal route are all different.
What a credentialing seat does in California
Applications, revalidations and payer follow-up, with every enrollment's status visible.
Medi-Cal is not one enrollment but one per plan, and every one of them has a revalidation date that stops payment when it passes. That calendar is the work.
- Initial applications prepared and submitted
- Revalidations tracked ahead of the deadline
- CAQH kept current
- Payer follow-up until an effective date is issued
- Status of every enrollment visible to you
- Worked during California business hours, not queued overnight
For the statute behind all of this — California’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the California billing page.
Medi-Cal, in practice
Medi-Cal is overwhelmingly managed care: DHCS describes members in all 58 counties receiving care through five managed care models — Two-Plan, County Organized Health Systems (COHS), Geographic Managed Care (GMC), Regional Model, and Single-Plan — so which plan(s) a biller deals with depends entirely on the county's model; a fee-for-service Medi-Cal residual remains for some services and populations. Source
Working California hours
California runs on Pacific time, 13 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 10pm to 6am, and 9pm to 5am once the clocks go forward. Pakistan does not observe daylight saving, so the shift moves on this side rather than yours.
That is the part that decides whether follow-up happens at all: a payer’s phone lines are open on California hours and nobody else’s.
What it costs in California
$2,450
Per seat, per month, in US dollars — $29,400 a year for one full-time person, forty hours a week, on California hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in California run $1,700 to $2,800; the full list is published.
That is the entire invoice. Run your own figures against a percentage vendor or a hire rather than take ours.
Getting started in California
About a week from a signed agreement to a person working your queue, and that week of training on your workflow is not billed on top. The work happens in your own system under a login you issue, so there is nothing to migrate and nothing to install. The week, step by step, and what is signed before anyone has access.
Questions
Do you work with California practices?
Yes. California accounts are worked during California office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about California?
Medi-Cal claims run through a separate submission path from commercial payers, and the timely filing window is shorter than most practices assume.
How long do we have to file a Medi-Cal claim?
By the end of the sixth month following the month of service, measured from the month of service, not the day — a 3 April service is due by 31 October. Adjustment or reconsideration within six months of the payment or denial date; an RTD must come back within 60 days. Past that date a claim is not late, it is unpayable, and no appeal recovers it. Source: Cal. Code Regs. tit. 22, § 51008 — Bills for Service.
When does a California payer have to pay a clean claim?
30 calendar days for a complete claim, with no separate deadline for electronic and paper. Health and Safety Code 1371 was re-enacted by Stats. 2024, Ch. 763 and this replaced the older 30-working-day rule. A claim sitting past that is not merely late, it is late against a statute, and the follow-up call changes from "when might this be paid" to "this passed your statutory window on a specific date".
How much does credentialing cost in California?
$2,450 per seat per month — $29,400 a year for a full-time person, forty hours a week. Every seat price is published at softhomeglobal.com/pricing.
What hours will somebody actually be working our California queue?
California is on Pacific time, 13 hours behind Rawalpindi. The shift here runs 10pm to 6am so your seat is at a desk for your full working day, shifting to 9pm to 5am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle Medi-Cal as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. Medi-Cal has its own submission path, its own filing window and its own appeal route, and working it in the same worklist as commercial claims is how the deadlines get missed.
Is this a percentage of what you collect?
No — a flat monthly rate per seat, published at softhomeglobal.com/pricing. A percentage bills you most in your best month and points the vendor at the easy accounts.
What is the minimum commitment, and how quickly can somebody start?
One seat for one month, cancellable on thirty days notice, and about a week from a signed agreement to a person working your queue. The week of training is not billed. The steps are at softhomeglobal.com/how-it-works.
Is our patient data safe offshore?
A Business Associate Agreement is signed before anyone has access, and the work happens in your own system under a login you issue, so every action is attributable to a person in your audit trail. The controls are listed at softhomeglobal.com/security.
More for California
Next step
One seat on your California work
Twenty minutes on a call is enough to tell whether this fits. If it does not, I will say so.
Or write to ops@softhomeglobal.com