Credentialing Guru

10/02/2026

My friend Danielle has a new website dmedsolutions22.com

She offers some real solutions for credentialing and enrollment.

09/02/2026

Check out our new updated web-site. I love it.

Credentialing, payer enrollment and contracting for SUD treatment facilities, behavioral health groups and clinicians.

07/01/2026

The hardest part of running a small business ( or even a big one) is that people cheat you. They take advantage of your skills and your good nature. They nickel and dime your service pricing down, they don't pay their bills- gaslighting you that it is your fault- this or that.

Is it worth sending them to collections?

How do you protect yourself ?

Should you improve your agreements?

Sometimes you just move on.

It's tempting to just have a "hand shake" agreement via email or over the phone to secure a client but you are the one who ends up getting the boot and losing money.

Visit our library for a strong consulting agreement template. The agreement is customizable with attachments you can add for different situations.

https://livewise2023.gumroad.com/l/ukydq

06/25/2026

if you are new to credentialing and would like some learning material check out our library of resources.

livewise2023.gumroad.com

06/25/2026

I am fascinated by the advancements in technology - the things !!! you know all those things... that are created by imaginations and math.

Humanity spent thousands of years changing very slowly, then experienced exponential change beginning with the Industrial Revolution and especially after 1975

When I was in HS- we still learned how to use an abacus !

I joke with my grandkids that we didn't even have "color TV" and my Mom would have laughed and said "we didn't have TV".

Innovations now build upon previous innovations.
Global communication spreads ideas instantly.
Computing accelerates research.
Billions of people can contribute knowledge simultaneously.
Scientific advances occur across multiple fields at once.

The printing press changed the world in 1450. The average person today has access to more information in a pocket than most national libraries contained 100 years ago.

That being said- lets not forget the joy of reading a paper book. Using pen and paper. Cooking from scratch. Gardening. Not everything needs to be in an app or on your phone. Lets not let go of the magic of creation.

Giggling to myself that I am speech texting on my phone into this app to make this post.

If you want to start your own credentialing business - lets talk. We use the best modern systems and no abacus's to solve problems.

ifccredentialing.com

06/23/2026

Are you a provider needing assistance with payer enrollment?

Facilities are our specialty. Substance abuse is the crisis of our day ! So much need and so much shortage of services. so many things to deal with. shortage of staff, and no money for treatment !

Payers are constricting access to providers to join the networks. which doesnt make sense but it is happening. We hear these complaints all across the healthcare field.

How can we help you ? We have been able to create a system of process that attacks the enrollment process from every angle.

It can feel overwhelming when the process take 6-9 months on a good day. Yes that's true. It can feel overwhelming when I send you a 9 page onboarding form. Yes 9 pages. but if it is not complete... I will keep asking you for information. But once you have that completed you will have a form that you can use with payers until you close your doors. It is worth the time it takes to do it right the first time.

There is no way on the planet you will get a county medi-cal contract if you don't have a solid stff roster, a detailed program descriptions, all the licenses, audited financials... and more!

Payers hate you. They bury you with conditions and revision requests. They offshore call centers, you cant talk to someone, they hide behind portals and they are also... understaffed and overwhelmed. They create departments and rules for substance abuse that don't apply to other levels of care.

So let us help you. Even if you are already contracted with some payers but want to expand... or you want to tackle adding Medicaid. Do you want to add locations... just send me an email.

We are not off-shore ! [email protected]

06/05/2026

AI IS EVERYWHERE ! I love AI.

it is a great tool to assist me in my work. I can ask it questions, it can find resources for me, it can create workflows and spreadsheets for me... but !!!!

the latest craze of course is this idea of handing off credentialing and payer enrollment to AI.

I see a growing number of companies pitching they are AI built and it will make a providers credentialing life better... no. we are not there yet.

Part of the trouble will be the payers themselves have such broken antiquated systems- AI on the provider end can't improve on that.

These platforms are trying to turn a highly customized, strategic compliance process into a assembly-line factory. For basic provider data cleanup? It's a step up. For complex facility enrollment and contracting? The human expert still ends up doing the heavy lifting to prevent a compliance disaster.

Don't be tempted to use an AI credentialing company for your provider needs. Not yet.

ifccredentialing.com

06/03/2026

New providers often don't know how to grow their practice in alignment with payer objectives. It's good to ask questions?

These are the questions I hear:

How do I negotiate reimbursement rates?

How do I build a value based program?

How do we prove that value?

On the surface those don't have anything to do with "credentialing and payer enrollment" ???? or do they? Yes they do. After verifying your credentials a payer wants to know you can provider value services to their member. That is your program description. It is what sets you apart from other providers.

The provider needs to have a revenue strategy. cash pay + insurance from commercial payers and/or/not government payers. The honest truth is payers don't want to pay. Just ask any billing person how frustrating claims processing is. So providers need to establish their value up front.

message me if you want help.

06/02/2026

When I onboard a new Facility client - I give them a 12 page onboarding form to fill out. It never fails- it comes back half empty. The objective is.... If you fill this all the way out with thoughtful and real answers ! I don't have to ask you later questions for each payer we want to contract you with. No two payer applications are the same. And some of them are quite detailed. Hello - they want to know what you do !

When I ask you "what are your psych testing protocols" it is not helpful to answer with " Whatever the therapist recommends and the client's ability to pay" .

you need help? message me.

04/14/2026

Is your facility growing—or just "applying"? 🛑
For years, I’ve been known as the Credentialing Guru. But in the 2026 landscape, "just getting credentialed" isn't enough to keep a facility's doors open. Between closed panels, narrow networks, and shifting payer requirements, the old ways of simply filling out forms are failing.

I’m reframing how we help the SUD and Behavioral Health community. We aren't just checking boxes; we are architecting Network Access.

How can we help you?

🏢 FOR FACILITY OWNERS & SUD PROVIDERS: Are you tired of hearing "the panel is closed"? We specialize in Strategic Market Access. We don’t just submit applications; we use data-driven advocacy and network adequacy analysis to force payers to the table. If you are looking to secure high-leverage contracts or expand your service lines (like Teen SUD or JUSTICE DIRECTED CARE), we provide the executive-level strategy to make it happen.

💼 FOR CREDENTIALING PROFESSIONALS: Are you ready to move beyond data entry? The industry is shifting. To survive as a pro in 2026, you need to understand Payer Portfolio Strategy. I’m here to help you level up from "clerical support" to a "Strategic Partner" for the facilities you serve.

Especially in saturated markets in So. Calif or Florida... It isn't as simple as filling out applications anymore.

The 2026 market is becoming more an more restricted, but the opportunities are there for those who know how to find the leverage.

👇 Which one are you? Drop a comment below or DM me. Let’s talk about how we secure your seat at the payer table.