Use cases by role

Agent FM for credentialing and healthcare ops

One quietly lapsed license can pull a provider off the schedule, which is why the quarter keeps dissolving into CAQH re-attestations, payer status checks, and a tracker that is only as current as your last long afternoon.

Every date Agent FM logs is verified at the source and traceable to it, and it pauses at each attestation and submission step so nothing is filed without you.

The plays

The quarterly sweep

It reviews the CAQH profile against your credentialing sheet, pauses at the attestation for your sign-off, then walks the payer portals and logs every expiration it finds.

Re-attest CAQH and sweep the payer portals for expirationsView →The enrollment pulse

Each Wednesday it checks every pending application in Availity and PECOS and notes exactly what each one is stuck on: documents, signatures, or payer review.

Chase our pending payer enrollments across the portalsView →Lapse watch

Monthly it verifies every license and cert on the roster at the source, Nursys included, and briefs you on who lapses soonest and what is already in renewal.

Watch the roster for credentials about to lapseView →Denial worklist

It sweeps the clearinghouse for denied claims, groups them by reason with the likely fix noted, and flags the timely filing deadlines getting close.

Build the denial worklist from the clearinghouseView →

The collection

Re-attest [provider]'s CAQH profile and sweep the payer portals for anything expiring.
Check status on every pending payer enrollment and note what each application is stuck on.
Sweep the roster's licenses and certs and brief me on everything lapsing in [window].
Sweep the clearinghouse for denied claims, sort by reason, and build the resubmission worklist.
Verify licenses for the [count] new clinicians on Nursys and the state boards, update the tracker.
Draft reminder emails to every provider with a credential expiring in [window].

Your attention goes back to providers and payers instead of the portals between them. Get early access and put the portal sweep first in line when access opens.

From the blog