Complimentary from the Center
Written for the desk that keeps the claims moving.
- The payer grid
- What does each insurer require?
- The application
- What do I need before I start?
- Credentialing
- What are the approval steps, and what has to be kept current?
- Claims
- What to check on the first claim, and what to do with a denial.
- Source notes
- Where did this come from?
No form between you and the guide. It is yours either way.
The Credentialing Cheat-Sheet is complete on its own. It answers one bounded question: what enrolling a Collaborative Care team in Michigan actually involves. It is not a sample of something else.
Tracking one practice’s enrollments and recredentialing dates, and working denials as they arrive, are ongoing operational work rather than the rest of this document. Public guidance can explain a rule. Your state, licenses, payers, contracts and staffing decide what applies to you. Kedge Marketplace is the separate platform for that individualized work.
Joining a network is a project. Nobody schedules it.
The Cheat-Sheet is the practical half. It puts the payer requirements, the documents, and the billing mechanics in one place, so the practice does not have to reconstruct the process from scratch.
Figure 01
The ledger nobody keeps.
One clinician, one insurer, one enrollment. Every line is real work. We do not have a defensible total for these fields.
- Application ?
- Entering practice and clinician information into the insurer’s application.
- Documents ?
- Licenses, certificates, insurance, and everything they ask for twice.
- Follow-up ?
- Calls and portal checks to find out where it stands.
- Enrollment corrections ?
- Work repeated before approval, because something was missing or wrong.
- Waiting ?
- Elapsed days between submitting and being able to bill.
- Recredentialing ?
- Doing much of it again on the payer’s own clock.
- Claim denial work ?
- Staff time spent fixing claims after participation begins.
- Total staff time ?
- The working hours one enrollment costs the practice.
Two clocks matter
Staff time. How many working hours the practice spends on enrollment.
Elapsed time. How long the process takes from application to participation.
A four-month enrollment does not mean four months of staff labour. This study measures both.
We have not put numbers in these fields because we do not have defensible ones. The people who do this work do.
What does insurance participation actually cost a practice?
Public data can tell us which clinicians are enrolled with which payers. It cannot tell us what the practice spent getting there: whose hours, how many, across how many weeks, and how much of it had to be done more than once.
The practice pays for that administrative work, and it is largely invisible in the enrollment record. Measuring it is the study.
A note on the rulesRequirements differ by payer and change over time, which is part of why the work is expensive. The Cheat-Sheet states what the public payer pages and CMS booklet MLN909432 say, with the date we checked. Dated notifications when something changes for your practice are the Brief Wire at Kedge.
The exchange · about five minutes
Five minutes, if the Cheat-Sheet earned them.
The people doing this work can fill in the ledger. Five minutes on enrollment time, follow-up, corrections, denials, and repeated work turns those question marks into evidence the field can use.
Findings go to respondents first.
About 5 minutes
Staff hours · elapsed time · who does the work · corrections and re-dos · recredentialing · claim denials
The survey
The study is not collecting responses yet.
When it opens, the invitation you received will return you to this page. The guide above is complete and yours to use now.
At the end, three permissions are asked separately: whether we may follow up, whether we may quote you anonymously, and whether you want the findings. None is required. You will see any proposed quote before we use it.