CASE STUDY

Credentialing Turnaround Time – Colorado Client.

Overview

This is How Cred2Bill impacts our client’s bottom line. With new legislation and failing efficiencies at the Payer side, our workflows and processes make that difference. Cred2Bill staff does not just submit applications, we are strategic and collaborative and build relationships with Payers to help our clients.

The Challenge

An Emergency Dept Physician approval timeline – Colorado Rural Health Hospital. Payers’ normal approval timeline is 60-90 days.

The revenue loss per week of a credentialing delay for an Emergency Medicine provider is approximately $10,000.

PayerStatusEffective DateApp Submission DateDays for Approval
AetnaActive9/26/20258/19/202538
Blue Cross Blue Shield (BCBS)Active8/22/20258/19/20253
CignaActive9/15/20258/19/202527
ClaritevActive8/25/20258/19/20256
Colorado Access HMOActive9/15/20259/9/20256
Health First Colorado (Medicaid)Active7/15/20257/17/20252
MedicareActive7/15/20256/30/202515
Simplified Benefits AdministratorsActive7/15/20257/18/20253
T-5Active7/15/20257/23/20258
TriWest (VA)Active7/15/20257/18/20253
Midland's ChoiceResubmitted8/19/2025
United Healthcare (UHC)Active8/21/20258/19/20252
VariableExample ValueNotes
Encounters per day12Typical ED volume per provider
Reimbursement per encounter$175Blended payer mix (commercial + Medicare/Medicaid)
Shifts per month20About 5 shifts per week
Average shift length10-12 hoursStandard EM shift

Weekly Revenue Loss Calculation for 1 EM Physician

Delay DurationRevenue Loss (per provider)
1 Week$10,500
2 Weeks$21,000
3 Weeks$31,500
4 Weeks = 1 Month$42,000
Delay DurationRevenue Loss (per NP/PA/APP)
1 Week$8,925
4 Weeks$35,700

The Solution

Our relationships with payers combined with completeness, and accuracy of submission the first time impacts approval days.

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