Credentialing & Enrollment
Credentialing & Enrollment from Soft Home Global costs $2,200 per seat per month. That is one full time trained person, forty hours a week, working United States business hours inside your own system. One seat, one month, cancel any time.
Applications, revalidations and payer follow-up, with every enrollment's status visible.
What the seat actually does
- 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
What it costs
$2,200
Per seat, per month, in US dollars. Full time, forty hours a week, on US hours — not per hour, not per claim, and never a share of your collections.
Compare against the other 21 roles →
The denial codes this seat works
8 codes, grouped the way the queue is worked rather than by number. Each one links to what causes it, the order to work it, and how to stop it recurring.
Worked by being fixed in credentialing, not on the claim
- CO-B7 — Provider not eligible that dayA credentialing or enrollment problem rather than a claim problem: nothing this provider bills to this payer will pay until it is fixed, and it is rarely one claim.
- CO-185 — Rendering provider not eligibleThe payer does not accept this provider as eligible for this service — an enrollment, credentialing or scope-of-practice problem rather than a coding one.
- CO-8 — Procedure and provider type disagreeThe payer does not expect a provider of this specialty to bill this code, based on the taxonomy attached to the claim.
- CO-183 — Referring provider not eligibleSomebody is named as the referring provider who the payer will not accept in that role.
- CO-184 — Ordering provider not eligibleThe provider named as ordering the service is not accepted by the payer in that role.
- CO-242 — Provider out of networkThe plan pays only for its own network, and this provider was not in it for this service.
Worked by being appealed with clinical documentation
- CO-170 — Provider type not paidThe service may be covered, but not when delivered or billed by a provider of this type.
Worked by being corrected and resubmitted
- N290 — Rendering provider NPI invalidThe NPI of the clinician who performed the service is missing from the claim, is not a valid NPI, or is not one the payer has linked to your group.
Working a denied claim costs $57.23 per denied claim in administrative time (source) and about about 90% of initially denied claims are eventually paid. The reason they sit is almost never that nobody knows how. It is that nobody has the hours.
How a seat starts
You issue one named login. We sign the Business Associate Agreement before it is used. We agree the numbers you will judge the seat on, which you pick and you measure. Then we train for about a week on your workflow and the seat starts. Every Friday you get a written report of what was done, what the numbers were, and what went wrong.
Questions
How much does credentialing & enrollment cost?
$2,200 per seat per month. That is a full time person, forty hours a week, working United States business hours. Not per hour, not per claim, and not a percentage of what you collect.
Is there a minimum contract?
One seat for one month, cancellable with thirty days notice. There is no annual lock-in.
Do we have to change systems?
No. The work happens inside whatever you already use, through a named login you issue. We do not sell software and we do not route your data through anything of ours.
How quickly can a seat start?
About a week from the agreement, which covers training on your workflow, your payer mix and your system. You are not charged extra for that week.
Next step
Try one credentialing & enrollment seat for a month
$2,200 for the month. If it does not earn its keep, cancel it. Twenty minutes on a call is enough to tell whether it fits.
Or write to ops@softhomeglobal.com