How a 3-provider practice cut 90+ day insurance AR by two-thirds
A focused clean-up and a fixed follow-up cadence turned stalled claims into cash in one quarter.
Practice2-location group adding an associate
SpecialtyGeneral dentistry
StateTexas
Timeline75 days
The challenge
This is an illustrative scenario based on common patterns we see; it does not describe a specific client.
A new associate was scheduled to start in six weeks, but no applications had been filed and the CAQH profile had not been attested. The practice risked billing out-of-network for its largest PPOs.
What we did
- Clean the dataAligned NPPES, license and CAQH details; uploaded current malpractice certificate.
- Prioritize networksRanked PPOs by patient volume and fee schedule.
- Submit and trackFiled applications and followed up every 10 days.
- Gate the scheduleBooked the associate only with plans that were effective.
Results
Major PPOs effective at start4 of 5from 0 of 5
Out-of-network claims in first month6from Projected 60+
CAQH attestation statusCurrentfrom Expired
Lessons for your practice
- Start credentialing the day the contract is signed.
- Keep CAQH attested every 120 days.
- Schedule by network status until effective dates are confirmed.
Services involved
- Credentialing
- Insurance Verification
Illustrative scenario: a composite example built from common patterns in dental billing. Figures are representative, not results from a specific client. Your results depend on payer mix, volume and starting point.