When a physician group hires, the new provider starts seeing patients on day one – but payer enrollment becomes effective 60 to 150 days later depending on the payer. What happens to the claims in that gap determines whether the group loses a quarter of that provider revenue.

The Three Bad Options

Hold the claims, and the slower payers push them past timely filing. Bill under a supervising physician, which is only compliant in narrow incident-to circumstances and is audit exposure everywhere else. Or bill, take the denial, and rebill retroactively once enrollment lands – which some payers honor and others do not.

Why Finance Never Sees It

The loss does not book as a denial trend. It surfaces as timely-filing write-offs, contractual adjustments, and bad debt – categories reviewed in aggregate and rarely traced to a root cause. The revenue was earned; the loss has no owner.

The Metric That Exposes It

Days from provider start date to first paid claim, by payer, for every provider added in the last 24 months. A wide spread means enrollment lag is being absorbed as write-offs. Groups that measure it can then fix it: begin enrollment at signed offer rather than start date, use payer-specific retro-billing windows deliberately, and sequence the credentialing packet by each payer known processing time.

Delegated Credentialing and CAQH Hygiene

Groups above a certain size can pursue delegated credentialing agreements with their largest payers, collapsing the lag from months to days. Below that size, CAQH profile hygiene – attestations current, documents unexpired – is the single highest-leverage habit, because a stale CAQH profile silently restarts the clock.

Revenant Care runs billing operations for physician groups. Every report specification in this guide is available via our contact page – usable with or without us.