Credentialing in Massachusetts
Soft Home Global provides payer enrollment, revalidation and follow-up for Massachusetts practices and billing companies at $2,400 per seat per month. Full time, worked during Massachusetts business hours, inside your own system.
What is specific to Massachusetts
Most MassHealth members receive care through Accountable Care Organizations or managed care plans rather than straight fee-for-service, and the commercial market is concentrated among regional insurers led by Blue Cross Blue Shield of Massachusetts.
Massachusetts’s Medicaid programme is MassHealth. Practices with a meaningful MassHealth 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 Massachusetts
Applications, revalidations and payer follow-up, with every enrollment's status visible.
MassHealth 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 Massachusetts business hours, not queued overnight
For the statute behind all of this — Massachusetts’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the Massachusetts billing page.
MassHealth, in practice
MassHealth is ACO-led rather than MCO-led: state data (Sept 2025) show enrollment split across 15 Accountable Care Partnership Plans (ACPPs) and 2 Primary Care ACOs (Community Care Cooperative and Revere Health Choice), with only 2 MCOs remaining (WellSense and Tufts Health Public Plans), plus the PCC Plan and fee-for-service, and SCO / One Care / PACE for dual eligibles. Source
Working Massachusetts hours
Massachusetts runs on Eastern time, 10 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 7pm to 3am, and 6pm to 2am 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 Massachusetts hours and nobody else’s.
What it costs in Massachusetts
$2,400
Per seat, per month, in US dollars — $28,800 a year for one full-time person, forty hours a week, on Massachusetts hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Massachusetts run $1,650 to $2,750; 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 Massachusetts
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 Massachusetts practices?
Yes. Massachusetts accounts are worked during Massachusetts office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Massachusetts?
Most MassHealth members receive care through Accountable Care Organizations or managed care plans rather than straight fee-for-service, and the commercial market is concentrated among regional insurers led by Blue Cross Blue Shield of Massachusetts.
How long do we have to file a MassHealth claim?
90 days from the date of service, or from another insurer's explanation of benefits, measured from the date of service, or the date of the other insurer's EOB. Waivers only for retroactive membership, a member who did not disclose eligibility, or an exception MassHealth authorises expressly. Past that date a claim is not late, it is unpayable, and no appeal recovers it. Source: 130 CMR 450.309 — Time Limitation on Submission of Claims: General Requirements.
When does a Massachusetts payer have to pay a clean claim?
45 days from receipt of completed reimbursement forms to pay, deny in writing, or request additional information; interest of 1.5% per month (max 18%/yr) accrues after that. 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 Massachusetts?
$2,400 per seat per month — $28,800 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 Massachusetts queue?
Massachusetts is on Eastern time, 10 hours behind Rawalpindi. The shift here runs 7pm to 3am so your seat is at a desk for your full working day, shifting to 6pm to 2am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle MassHealth as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. MassHealth 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 Massachusetts
Next step
One seat on your Massachusetts 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