Case Study: Multi-Specialty Medical Organization establishes a credentialing source of truth and recoups $400,000 with QGenda Credentialing

Multi-Specialty Medical Organization Establishes Central Source of Truth, Streamlines Processes, and Ensures Accuracy with QGenda Credentialing

Multi-Specialty Medical Organization, a 12-location healthcare provider with two main service lines, faced major credentialing challenges after losing its in-house specialist. The organization relied on manual, paper-based processes and spreadsheets, had limited credentialing expertise, and was dealing with more than $500,000 in denied claims over eight months. It also lacked confidence that it was fully compliant with policies and procedures. QGenda Credentialing was the product used to address these issues.

QGenda Credentialing reviewed the organization’s credentialing and denial processes, identified issues with third-party billing, and helped re-submit backlogged Medicare claims while creating a formal, centralized credentialing workflow. QGenda established a single source of truth for documents, improved onboarding, and added ongoing monitoring to keep files current and compliant. As a result, the organization recovered 80% of outstanding claims and recouped $400,000, while also speeding provider onboarding so patients could be treated sooner.