Billing and credentialing for a new behavioral-health program.

Start when you sign the lease. Your organizational NPI, tax ID and state license have to exist before most payer enrollment can begin, and each payer then runs on its own clock.

The order is entity and license first, then NPI, then payer applications as soon as each has what it needs. EHR and clearinghouse setup run alongside. One rule is fixed: no claim goes to a payer until that payer confirms enrollment and an effective date.

The work is CAQH setup, payer applications, contracting where a network contract applies, and EDI and ERA enrollment. Each provider is credentialed on top of the organization.

Plan on roughly 60 to 120 days per payer, and it varies by payer and state. Medicaid runs on each state's own process. We file early and track every application to a decision.

A claim goes out while enrollment is still pending, or before the payer's effective date, and it bounces before anyone looks at coverage. Half-finished EDI and ERA setup causes a second wave: claims transmit but remittance never routes back. A tracked enrollment list prevents both.

We confirm the entity, register the NPI if needed, and file payer applications in the order that gets you paid soonest. We set claim rules for each level of care you will run.

Sample claims are built and checked against payer rules before any real claim goes out, and claim status reporting starts from day one. Your written scope sets the exact order against your open date.

Nothing has to be finished. We just need to know where each item stands.

The billing setup on this page is a program build. The assessment comes first and produces a written scope and a fixed price.

Once your program is live, ongoing billing runs under HRI Managed on one price rule: a monthly minimum or a percentage of what we collect, whichever is greater, never both. Credentialing, licensing support and accreditation readiness are priced separately, per service, in writing, whether or not you also run billing through HRI.