Key takeaways
- A medical group offering cardiology and weight management services started in California and is now credentialed in 5 states.
- Since 2023 we have actively managed credentialing for more than 30 of its providers.
- The group has more than 600 active payer enrollments, and we also linked it with many local medical practices in other states.
- Results vary by group, payer and state.
The situation
A medical group offering cardiology and weight management services started in California. As it grew, its providers needed to be credentialed and enrolled with the payers it wanted to accept, first in California and then in other states. Each state added its own licensing board, Medicaid program and mix of payers, and each new provider added applications with every payer.
The group is anonymized here, and no patient, provider or payer-specific details are shared.
What we did
We have managed the group’s provider credentialing and payer enrollment since 2023. In general terms, that meant:
- Managing credentialing for more than 30 providers on an ongoing basis, not as a one-time project.
- Keeping one provider-by-payer tracker so every application, status and effective date was visible.
- Linking the group with many local medical practices in the other states.
- Tracking re-credentialing, revalidation and attestation dates so enrollments stay active.
- Coordinating each new state before applications were filed.
The result
The group started in California and is now credentialed in 5 states. Since 2023 we have actively managed credentialing for more than 30 of its providers, and the group has more than 600 active payer enrollments.
What this shows
Credentialing a medical group is ongoing work, not a one-time project. Providers join, payers revalidate, attestations expire and new states open. A group stays enrolled when someone owns the calendar and the tracker, month after month. In our experience, that continuity matters more than speed on any single application.
Frequently asked questions
What does “active payer enrollment” mean here?
One provider enrolled with one payer counts as one enrollment. With more than 30 providers, each enrolled with about 20 payers on average, the total passes 600.
Can MedWork Services support medical groups that expand beyond one state?
Yes. We support administrative coordination across all 50 states, subject to each state’s, profession’s and payer’s requirements. Results vary by group, payer and state.
Is credentialing a one-time project?
No. Re-credentialing, revalidation and attestation continue after the first approvals, so it works best as an ongoing process with a clear owner.
Planning to expand into a new state or add providers?
We can review your credentialing plan and timeline before you grow.
The initial audit is complimentary.
Related reading: Case Study: Supporting a Behavioral Health Group From 1 Provider to 100+ Across 20 States · How Long Does Provider Enrollment Really Take?
About the author
Kamran Muzaffar is the founder of MedWork Services and has 12 years of experience in healthcare revenue operations. He oversees the Billing, Credentialing and Licensing departments and works directly with providers on enrollment and revenue recovery.
General information only. Payer rules and regulations change, so confirm current requirements for your situation.