What it looks like when pie handles credentialing

When your practice works with pie for credentialing, you are adding a focused partner that takes responsibility for the day to day credentialing work, tracking, and follow up, while your team keeps its attention on patients and operations. You stay in control of decisions. We handle the mechanics and the monitoring.

This is what that looks like from first conversation through ongoing maintenance.

Step 0: Free initial consultation

Before anything else, we start with a short, no cost consultation.

On that call, we:

• Walk through your current provider roster, locations, and payor list
• Talk about where credentialing is working and where it is breaking down
• Outline what a credentialing plan and maintenance model would look like for your situation

If it is not a fit, you at least leave with a clearer picture of what you have and what is missing. If it is a fit, we move into onboarding.

Step 1: Digital onboarding and credentialing assessment

After the consultation, we do not jump straight into “maintenance.” First, we do the assessment and setup work that gives us and you a true picture of where things stand.

You can choose between full service onboarding, where we drive most of the data collection, or a more self service approach if your team prefers to load some details directly.

This Credentialing Assessment and Setup phase covers both inherited work and net new work.

For clients with existing credentialing in place, we:

• Collect and review existing rosters, contracts, participation letters, and prior vendor records
• Verify current provider and facility enrollments and effective dates with payors, not just from internal documents
• Confirm the current payor mix and how each provider is actually enrolled today
• Document recredentialing, revalidation, and key renewal timelines from payor sources
• Map what is active, what is pending, what is unclear, and where there are gaps

For new launches or new lines of business, we:

• Do payor research by market, specialty, and product to determine which plans matter and how they handle your provider type
• Confirm enrollment pathways, group versus individual structures, and any behavioral health or carve out entities
• Cross check what we already know from our internal database with current plan documentation or payor confirmation, so we are working from the most recent rules, not assumptions

In every case, we:

• Digitally onboard entities and locations and collect required organizational documentation
• Create and validate provider profiles
• Populate your client portal with this verified baseline so you have one place to see the full picture

This assessment work is what lets us start from reality instead of guesses.

Step 2: From assessment to active setup work

Once we have that baseline, we move into active setup. This is still initial work, not yet steady maintenance.

For both inherited and new credentialing, this phase includes:

• Preparing and submitting any missing or incomplete enrollments identified in the assessment
• Updating CAQH and other shared data sources so they match what payors actually need now
• Correcting known issues in payor records, such as wrong tax IDs, NPIs, addresses, or group affiliations
• Initiating new applications and contracting work based on the payor research and payor mix decisions we have already agreed on with you

As this setup work moves forward, everything is logged in your portal so you and your team can see progress without having to ask for a status email.

Step 3: Credentialing lives in your client portal

Once onboarding and initial setup are in place, your credentialing picture is no longer a set of spreadsheets and emails. It lives in the client portal.

Your team can:

• See providers, entities, and payors on a single screen
• Track enrollments, recredentialing, and maintenance work in one place
• See what is submitted, what is pending, and what has been approved
• Spot upcoming deadlines for recredentialing and revalidation before they become urgent

The goal is for credentialing status to be visible and easy to get to, without having to chase updates.

Step 4: Ongoing maintenance as a portfolio client

After the baseline and setup are in motion and documented, you move fully into ongoing credentialing maintenance as a portfolio client. At that point, pie operates as an extension of your operations and billing teams specifically for credentialing.

Ongoing maintenance includes:

• Active management of recredentialing and revalidation cycles
• Continuous CAQH maintenance and attestations so profiles stay current
• Payor directory and demographic updates to keep billing and referrals clean
• License, malpractice, and key document tracking that ties into credentialing timelines
• Routine payor follow up related to maintenance and recredentialing activity

All of that work is logged in the portal so you can see what is happening without having to dig for it.

Step 5: Reports and meetings, on a set rhythm

We do not wait for problems to talk.

Your communication cadence looks like:

• Twice monthly credentialing reports that summarize current status, recent activity, and what is coming up next
• A standing monthly meeting to walk through those updates, talk through decisions, and align on priorities
• As needed contact by email or phone in between, with the portal as the shared source of truth

That rhythm is meant to keep leadership, billing, and pie on the same page without you having to pull numbers together yourself.

Step 6: Clear scope, pricing, and boundaries

From the start, we are explicit about:

• What is included in ongoing maintenance for portfolio clients
• What requires a separate project or agreement, such as larger expansions or special initiatives
• How fees work, including flat per provider maintenance and pass through third party costs without markup

The idea is that you are not guessing what is covered or worrying about surprise line items every time a payor asks for something new.

Step 7: Standards and guardrails behind the scenes

Behind the visible work, there is structure:

• Primary source verification of provider credentials as part of credentialing and enrollment services
• Compliance, security, and privacy standards for the systems and data we touch, including PHI where applicable
• Clear expectations about not scheduling services that depend on credentialing until payors have actually confirmed approval

You keep ownership of your practice and your risk decisions. We bring the systems, checks, and habits that make credentialing reliable.

What it feels like for your team

When pie is handling credentialing, it feels like:

• Having someone whose job is to think about credentialing every day, so you do not have to
• Being able to answer “are we good with this payor” with specifics instead of guesses
• Fewer surprises and fewer last minute scrambles when something renews or changes
• A partner you can email or meet with who already knows your roster and your payors

If you want to talk about whether this model makes sense for your practice, we start with a conversation, walk through your situation, and go from there.