MTB Credentialing Services

03/15/2026

With Lani Cabral Pasao – I'm on a streak! I've been a top fan for 3 months in a row. 🎉

02/15/2026

Referral incentives available 🙃

02/04/2026

12/16/2025

D/B Credentialing and Enrollment.

Credentialing = Verify qualifications
Enrollment = Contract with payers to get paid

Credentialing:
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Credentialing is the process of verifying a provider’s professional qualifications.
It ensures the provider is trained, licensed, and competent to deliver care.

Purpose:
To confirm the provider meets the standards required by a hospital or health plan.

Enrollment:
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Enrollment is the process of linking a provider or group practice with insurance payers (Medicare, Medicaid, and commercial plans) so they can bill and receive reimbursement.

Purpose:
To ensure the provider is recognized by payers and can receive payment for services.

12/10/2025

Various factors contribute to claims issues, including credentialing, enrollment loading errors, taxonomy, NPI, and other concerns. As you are aware, many health systems have substantial unpaid Medicare Advantage claims that remain unresolved. These claims, aged 12-60 months, are often categorized as unpaid, underpaid, or written off after exhausting standard billing and appeals processes. We specialize in recovering aged claims (1-5 years old) through a 100% contingency model, achieving success rates exceeding 90%.

12/10/2025

The P.O.T.E.N.T.I.A.L. Scan
A simple way to read who can grow, not just who has grown
P — Persistence
O — Ownership
T — Teachability
E — Energy
N — Nerves under pressure
T — Thinking depth
I — Initiative

12/10/2025

12/07/2025

My expertise is handling Delegated Group or individual Multi-Specialty Provider enrollments in multiple states. It’s has been instrumental in enhancing provider onboarding and patient engagement. Alongside managing a credentialing & Enrollment database…

12/07/2025

Services:
Business Consulting • Healthcare Consulting • Management Consulting • Project Management • Leadership Development.

Top skills
Credentialing • Provider Enrollment • Process Improvement • Behavioral Health • Mental Health.

12/07/2025

$𝟰𝟴𝟳,𝟬𝟬𝟬.

That's what we found sitting in an orthopedic practice's "pending" queue last month.

Not denied. Not rejected.

Just sitting there. For 11 months.

Look, here's what happened, their clearinghouse was flagging claims for missing information, but nobody was checking the flags.

The claims never actually got submitted to the payer.

Knee replacements. Hip revisions. Spinal fusions.

Some of the highest-dollar procedures they do.

The practice administrator thought everything was fine because the clearinghouse wasn't showing errors.

The billers thought everything was fine because nothing came back denied.

Meanwhile, the payers never even saw the claims.

We resubmitted everything that was still within timely filing.

Recovered $𝟯𝟰𝟬𝗞 𝗶𝗻 𝟲 𝘄𝗲𝗲𝗸𝘀.

The other $147K?

𝗧𝗼𝗼 𝗹𝗮𝘁𝗲. 𝗚𝗼𝗻𝗲 𝗳𝗼𝗿𝗲𝘃𝗲𝗿.

To be honest, this is the part that kills me about orthopedic billing, the dollars are big enough that one process gap can cost you a surgeon's salary.

Before celebrating your clean claim rate, you might want to ask: are you actually checking your clearinghouse pending queue weekly?

Because if you're not, you could be leaving half a million dollars on the table and not even know it.

Suggestions…

That’s a lot of money! Revenue should check it every week and need to check what is issues with it… It might be Enrollment issues that is why they are not touching it… it is still in process or there’s other issues like referrals, taxonomy code, npi, etc… the status needs to be to In progress hold claims, In progress send claims as not participating, Not Billing, Not Participating or Participating to avoid an issue. Also, you have to create portal access for some payers and complete EFT/ERA. I recommend PaySpan, OptumPay, & Availity for tracking payments.

12/07/2025

Most jobs look fine on paper.
Until you count the sleepless nights.
That's the real cost of culture.

Because culture isn’t just what happens at work.
It’s how work makes people feel -
even after hours.

Most leaders still don’t see it.
They think culture lives in perks, posters, or policies.

They talk about “family,”
but act like performance machines.

They measure success in output -
not in the energy people have left.

Many workplaces look polished on paper
but feel heavy in real life.

The truth?
Culture is rarely what leaders say.
It’s what people cry about in the car
on their way home.

True leaders build cultures
that heal, not harm.

And you can feel it in their actions 👇

1. They don’t preach “work-life balance.”
They build work-life harmony -
where neither side breaks the other.

2. They don’t ask “How’s the project?”
They ask, “How are you doing in the project?”

3. They bring humanity into hard moments.
Feedback with empathy builds trust -
without it, it breaks people.

4. They correct behavior, not character.
Humble guidance grows people.
Judgment scars them.

5. They talk to people, not about them.
Because gossip quietly destroys
what trust takes years to build.

6. They know culture isn’t written in values on the wall.
It’s written in how people feel
walking out the door.

7. They build teams people don’t need to recover from.
No Sunday dread. No emotional hangover.
Just pride.

That’s the difference between a job that drains you
and a culture that sustains you.

Choose the second -
and lead others there.

The tone you set
becomes the culture you get.