Question 1

What is included in Konnext's out-of-network medical billing service?

Accepted Answer

Konnext's professional billing service covers claim preparation, submission and payer follow-up. Other tasks require a separate agreement. The engagement identifies the work assigned to Konnext and the responsibilities retained by the practice.

Question 2

Who does Konnext work with?

Accepted Answer

Konnext works with solo providers, group practices, healthcare facilities, practice administrators, and healthcare entrepreneurs across a range of specialties and stages of growth. The team reviews each practice's service needs, payer environment, systems, and operational goals before recommending a scope.

Question 3

Where does Konnext provide services?

Accepted Answer

Konnext supports healthcare providers nationwide across all 50 states. Payer programs, Medicaid requirements, licensing dependencies and operational rules remain specific to the provider, organization, state and plan.

Question 4

How quickly does Konnext respond to clients?

Accepted Answer

We guarantee a response to enquiries and existing-client messages within two business hours during Monday–Friday, 9 a.m.–6 p.m. Eastern. Messages received outside those hours receive a response the next business day. This is a response guarantee; resolving payer, claim or system issues may take longer.

Question 5

How are credentialing clients kept updated?

Accepted Answer

Your first status report is provided within 7–10 business days after the agreement is signed and all required information is received. Ongoing spreadsheet reports follow at mid-month and month-end. Reporting continues through the agreed credentialing scope.

Question 6

Does Konnext guarantee payer approval, contracts or reimbursement?

Accepted Answer

No. Payers control network availability, approvals, contracts, effective dates and claim adjudication. Konnext manages the approved administrative and revenue-cycle work, communication and follow-up but cannot guarantee third-party decisions or payment.

Question 7

What happens after I submit an inquiry?

Accepted Answer

A Konnext representative reviews the practice information and follows up using your preferred contact method. The first conversation confirms service fit, priorities and the appropriate next step.

Question 8

Can I send credentialing documents through this form?

Accepted Answer

No. This is a public inquiry form. After scope is confirmed, Konnext will provide an approved secure workflow for documents and sensitive information.

Question 9

How quickly will someone respond?

Accepted Answer

Konnext prioritizes timely business communication. Response timing may vary by submission time, inquiry type and business hours, so urgent requests should also be made by phone.

Question 10

What does Konnext Solutions do?

Accepted Answer

Konnext Solutions supports healthcare providers and practices with provider credentialing, medical billing and revenue-cycle management, denial management and insurance A/R recovery, practice start-up support, EHR/EMR setup and implementation, and practice-growth support. Services can be combined around the practice's priorities rather than treated as one-size-fits-all packages.

Question 11

Do you support practices nationwide?

Accepted Answer

Yes. Konnext supports healthcare providers and practices across the United States. Credentialing, payer, licensing, billing, and operational requirements can vary by state, payer, product, provider type, and specialty, so the final scope is based on the practice's specific situation.

Question 12

Do you require a long-term contract?

Accepted Answer

Konnext does not require long-term contracts. The service agreement defines the approved scope, fees, responsibilities, start date, and applicable notice or termination terms so both sides understand how the engagement will work before onboarding begins.

Question 13

What happens after I book a discovery call?

Accepted Answer

A Konnext team member will learn about your practice, current challenges, systems, providers, payer priorities, and goals. If the services are a fit, Konnext will recommend a tailored scope and provide clear next steps for proposal review, agreement, document collection, access, communication, and onboarding.

Question 14

What information will Konnext need to get started?

Accepted Answer

The exact list depends on the service. Common items include practice and provider details, NPI and tax/entity information, CAQH access or status, payer targets, existing enrollment records, current EHR or practice-management information, clearinghouse or portal access, billing and A/R reports, and relevant agreements. Konnext will provide a secure, service-specific checklist; do not submit patient information or protected health information through public website forms.

Question 15

How long does provider credentialing take?

Accepted Answer

Credentialing timelines vary by payer, provider type, specialty, location, application completeness, roster cycles, and whether additional information is requested. Many applications take approximately 30-120 days or longer. Konnext helps organize requirements, prepare and submit applications, track status, respond to follow-up requests, and keep the practice informed, but payer processing time is outside Konnext's control.

Question 16

Can Konnext guarantee payer enrollment or a specific effective date?

Accepted Answer

No. Final approval, participation, contract terms, effective dates, and network availability are determined by each payer. Konnext manages the credentialing work within the agreed scope and follows up diligently, but no credentialing company can guarantee payer acceptance, reimbursement, or a specific completion date.

Question 17

Can you help with CAQH, Medicare, Medicaid, and commercial payer enrollment?

Accepted Answer

Yes, when those items are included in the approved service scope. Support may include CAQH setup or reattestation, Medicare enrollment, state Medicaid enrollment, commercial payer applications, portal work, document collection, application tracking, and payer follow-up. Requirements and eligibility vary, and some government or payer work may require separate/add-on scope.

Question 18

What is provider credentialing?

Accepted Answer

Provider credentialing is the review of a clinician's identity, education, training, licensing, work history, malpractice coverage and other qualifications. Payer enrollment and contracting are related steps that determine whether and how the provider may participate in a payer network.

Question 19

Is credentialing the same as payer enrollment?

Accepted Answer

No. Credentialing evaluates the provider's qualifications and professional information. Enrollment connects the provider or organization to a payer's systems, while contracting establishes participation terms. The steps may overlap, but they are not interchangeable.

Question 20

Who will manage my credentialing project?

Accepted Answer

Konnext assigns a dedicated credentialing specialist who becomes your single point of contact from kickoff through completion of the agreed scope. The specialist coordinates readiness, submissions, payer follow-up, information requests and status reporting.

Question 21

When will I receive my first credentialing status report?

Accepted Answer

Your first status report is provided within 7–10 business days after the agreement is signed and all required information is received. The report summarizes application activity, open items, dependencies and next actions. This is a reporting commitment, not a payer approval commitment.

Question 22

How often will I receive credentialing updates?

Accepted Answer

Your assigned credentialing specialist provides spreadsheet status reports at mid-month and month-end until the agreed credentialing and contracting scope is complete and, where applicable, the payer-confirmed effective date is documented. If Konnext needs a document, signature or correction sooner, the specialist will contact you rather than wait for the next scheduled report.

Question 23

Can Konnext guarantee payer approval or an effective date?

Accepted Answer

No. Approval, network participation, panel availability, contract terms and effective dates are controlled by the payer or government program. Konnext can improve organization, completeness, follow-up and visibility, but cannot guarantee the payer's decision.

Question 24

Do you credential both individual providers and group practices?

Accepted Answer

Yes. Individual and group credentialing require different data and enrollment structures. We define which organization-level and provider-level actions are required before the project begins.

Question 25

Can you help with Medicare, Medicaid and commercial payers?

Accepted Answer

Yes. Konnext supports Medicare, state Medicaid programs and commercial payer enrollment. The exact payer list and pathway depend on the provider type, state, specialty, network availability and the practice's goals.

Question 26

Do you manage CAQH and PECOS?

Accepted Answer

Yes. Konnext supports provider profile preparation and maintenance in the DataSpring / CAQH Provider Data Portal and Medicare enrollment activity through PECOS. Access must be authorized through the applicable platform process; personal portal credentials should not be shared. Providers remain responsible for required reviews and attestations.

Question 27

Can you help with revalidation and ongoing maintenance?

Accepted Answer

Yes, within the agreed scope. We can review renewal requests, identify record updates, coordinate required submissions and help plan ongoing maintenance. Track each provider, entity and program separately, with the request, due-date source, supporting information, owner, submission evidence and next action. Provider confirmation, signatures and authorized access remain part of the handoff. Illustrative example, not a client record: A Medicaid renewal request is received, provider confirmation is outstanding and the practice contact owns the next response. Keep that dependency open. Submission or CAQH attestation alone does not confirm program renewal; retain the applicable payer or program's completion evidence.

Question 28

Can Konnext help after credentialing is complete?

Accepted Answer

Yes. Based on the practice's needs, Konnext can support EHR/EMR setup and implementation, additional payer enrollments, medical billing and revenue-cycle management. Before treating a payer relationship as active for in-network billing, confirm the applicable participation status, effective date and plan-specific requirements. Clinical and patient-access decisions remain with the practice.

Question 29

How is credentialing pricing determined?

Accepted Answer

Pricing is tailored after discovery based on provider count, payer count, states, provider type, practice structure, existing records, systems and project complexity. The approved scope, fees and any add-ons are disclosed before work begins.

Question 30

Do you provide credentialing support in all 50 states?

Accepted Answer

Konnext supports providers nationwide. State, program and payer requirements vary, so each project is scoped according to the provider's locations, services and target networks.

Question 31

What does a medical billing company do?

Accepted Answer

A medical billing company manages agreed parts of the claim and reimbursement workflow for a healthcare practice. Depending on scope, this can include claim preparation and submission, rejection correction, payment posting, denial follow-up, insurance A/R work, payer communication and reporting.

Question 32

What is included in Konnext medical billing services?

Accepted Answer

The final scope is customized. It may include charge and claim-readiness coordination, claim scrubbing and submission, rejection correction, payment posting, denial review, payer follow-up, insurance A/R management and mid-month and month-end reporting. Coding, eligibility, prior authorization, credentialing and focused recovery work can be added when approved.

Question 33

How is medical billing different from revenue cycle management?

Accepted Answer

Medical billing focuses on moving claims from charge information through submission, payer adjudication, payment posting and follow-up. Revenue cycle management is broader and can also include patient access, eligibility, prior authorization, coding, denial prevention, insurance A/R strategy, reporting and workflow improvement.

Question 34

Will we have a dedicated account manager?

Accepted Answer

Yes. Your assigned account contact coordinates questions, priorities and reporting for the agreed scope. This means an assigned point of contact, not exclusive full-time staffing.

Question 35

How quickly does Konnext respond?

Accepted Answer

We guarantee a response to enquiries and existing-client messages within two business hours during Monday–Friday, 9 a.m.–6 p.m. Eastern. Messages received outside those hours receive a response the next business day. This is a response guarantee; resolving payer, claim or system issues may take longer.

Question 36

How often will we receive billing reports?

Accepted Answer

Credentialing and billing clients receive spreadsheet status reports at mid-month and month-end. The detail depends on the approved scope and available system data, and your assigned account contact helps interpret trends, open risks and action items.

Question 37

Can Konnext work in our current EHR and clearinghouse?

Accepted Answer

In many cases, yes. Konnext has experience across multiple EHR, practice-management, clearinghouse and payer-portal environments. We review the current setup and access during discovery and onboarding before recommending any configuration or platform change.

Question 38

Does payer enrollment automatically activate claims, ERA and EFT?

Accepted Answer

No. Payer participation, electronic claim submission, electronic remittance advice (ERA) delivery and electronic funds transfer (EFT) can require separate setup and confirmation. The approved scope identifies the connections, responsible parties, available evidence and next action for each payer and system. Illustrative example, not a client record: Claims are accepted, but ERA delivery is unconfirmed. Keep that connection open with an owner and next validation; do not mark all setup complete. Routine posting should reconcile available remittance and payment information through the practice's approved workflow. Claim acceptance or setup completion does not guarantee payment.

Question 39

Does a clean claim guarantee payment?

Accepted Answer

No. A clean claim reduces preventable submission errors, but payment can still depend on active eligibility, benefits, authorization, medical necessity, documentation, coding, timely filing, coordination of benefits, payer policy and contract terms.

Question 40

How are medical billing services priced?

Accepted Answer

Pricing is customized to the selected services and the practice's size, specialty, systems, payer mix, provider count, claim or collection volume, current backlog, and operational complexity. After the discovery process, Konnext provides a clear proposal describing the scope, responsibilities, fees, and any separate or add-on services before work begins.

Question 41

What do you need for a billing assessment?

Accepted Answer

Useful starting information may include provider count, specialty, payer mix, current EHR and clearinghouse, approximate monthly claim or collection volume, denial trends and insurance A/R aging. Do not submit PHI, patient records or claim-level information through a public website form.

Question 42

What is included in medical billing and revenue-cycle support?

Accepted Answer

Depending on the agreed scope, support may include billing workflow setup, eligibility and claim-readiness coordination, electronic claim submission, rejection correction, payment posting, denial management, appeals support, insurance A/R follow-up, EDI/ERA/EFT coordination, reporting, and ongoing revenue-cycle communication. The final responsibilities and handoffs are documented during onboarding.

Question 43

Will we have to change our EHR or practice-management system?

Accepted Answer

Not necessarily. Konnext has experience working across multiple EHR, practice-management, clearinghouse, and payer-portal environments and will first evaluate the practice's current workflow. If a configuration, connection, or platform change would materially improve operations, the team will explain the reason, impact, and next steps before a decision is made.

Question 44

What is healthcare revenue cycle management?

Accepted Answer

Revenue cycle management is the connected process healthcare organizations use to manage the financial journey associated with patient care, from patient access and coverage verification through coding, billing, reimbursement and final account resolution.

Question 45

How is revenue cycle management different from medical billing?

Accepted Answer

Medical billing focuses primarily on preparing, submitting and following claims and posting payments. RCM is broader: it can include eligibility, prior authorization, coding, billing, denials, insurance A/R, reporting and workflow improvement. Konnext can provide a focused billing scope or a wider RCM engagement depending on the practice.

Question 46

Does Konnext require every RCM service to be bundled together?

Accepted Answer

No. The engagement is structured around the practice's needs. A practice may select full-service RCM, medical billing, coding, prior authorization, denial management, insurance A/R recovery, an audit, or another clearly defined combination.

Question 47

Can Konnext work with our current EHR and clearinghouse?

Accepted Answer

In many cases, yes. Konnext has experience across multiple EHR, practice-management, clearinghouse and payer-portal environments. The team reviews the current setup, access and workflow before recommending configuration or implementation changes.

Question 48

Can prior authorization prevent every denial?

Accepted Answer

No. Prior authorization can address an important pre-service requirement, but it does not guarantee payment. Reimbursement can still depend on active eligibility, benefits, medical necessity, documentation, coding, timely filing and other payer requirements.

Question 49

How quickly will Konnext respond to our team?

Accepted Answer

We guarantee a response to enquiries and existing-client messages within two business hours during Monday–Friday, 9 a.m.–6 p.m. Eastern. Messages received outside those hours receive a response the next business day. This is a response guarantee; resolving payer, claim or system issues may take longer.

Question 50

How often will we receive RCM reports?

Accepted Answer

Credentialing and billing clients receive spreadsheet status reports at mid-month and month-end. Reporting detail depends on the approved scope and available system data, and your assigned account contact helps explain trends, open risks and recommended actions.

Question 51

How are RCM services priced?

Accepted Answer

Pricing depends on the selected scope, specialty, provider count, systems, payer mix, claim or collection volume, backlog and operational complexity. After discovery, Konnext provides a clear proposal outlining responsibilities, fees and any separate services.

Question 52

What information is needed for an RCM assessment?

Accepted Answer

Useful starting information may include aging reports, denial reports, charge and payment trends, payer mix, provider count, current systems and the practice's primary concerns. Do not submit PHI, patient records or claim-level information through a public website form.

Question 53

What are medical coding services?

Accepted Answer

Medical coding services translate documented diagnoses, procedures, services and supplies into standardized codes used in healthcare transactions. The selected codes must be supportable by the record and applicable coding guidance. Coding does not replace the provider's responsibility for complete and accurate clinical documentation.

Question 54

Which code sets does Konnext support?

Accepted Answer

Depending on the approved outpatient or professional scope, work may involve ICD-10-CM diagnosis codes, CPT codes, HCPCS Level II codes and applicable modifiers. The exact code sets, specialties and service settings are confirmed before onboarding.

Question 55

Is medical coding the same as medical billing?

Accepted Answer

No. Coding converts documented clinical information into standardized codes. Billing uses approved charge and coding information to prepare, submit and follow claims, post payments and manage payer responses. A practice may outsource either service or connect both through a broader RCM engagement.

Question 56

Can accurate coding guarantee payment?

Accepted Answer

No. Supportable coding can reduce preventable errors, but payment can still depend on eligibility, benefits, authorization, medical necessity, payer policy, documentation, contracts, timely filing and claim submission requirements.

Question 57

Does Konnext perform coding audits?

Accepted Answer

Yes, when included in the approved scope. Audits may be sample-based, focused on a service line or driven by denial patterns. The methodology, sample, review period and reporting format are defined before work begins.

Question 58

How are documentation questions handled?

Accepted Answer

Questions follow an approved escalation process. Coding staff do not create clinical facts or use leading queries. The provider or authorized practice contact remains responsible for clarifying and completing the medical record.

Question 59

Can Konnext help with a coding backlog?

Accepted Answer

A defined backlog project may be available after the practice shares high-level information about specialty, setting, chart volume, date range, systems and documentation readiness. We confirm capacity, quality checks and turnaround expectations before launch.

Question 60

Will we receive coding reports?

Accepted Answer

Yes. Reporting is tailored to the engagement and may include volume, turnaround, held charts, audit findings, documentation dependencies, coding-related denials and recommended actions.

Question 61

Do you support every specialty and facility type?

Accepted Answer

Konnext supports multiple eligible outpatient specialties, but not every setting or coding project is automatically accepted. We confirm service setting, coder qualifications, system access and compliance requirements during discovery.

Question 62

What information is needed for a coding assessment?

Accepted Answer

Useful starting information includes specialty, provider count, care setting, approximate chart volume, EHR or practice-management system, current coding workflow, backlog size and common coding concerns. Do not submit PHI or medical records through the public form.

Question 63

What are eligibility and benefits verification services?

Accepted Answer

Eligibility and benefits verification services check available payer information before an applicable visit or service. The workflow may confirm coverage status, effective dates, plan details, service-specific benefits, patient-responsibility information, limitations and referral or authorization indicators. The exact fields and follow-up responsibilities are defined in the approved scope.

Question 64

Is insurance eligibility the same as benefits verification?

Accepted Answer

No. Eligibility generally answers whether the member has coverage for the applicable date. Benefits verification examines the available plan and service details, such as copay, coinsurance, deductible, limits and other returned information. They are usually performed together because active coverage alone does not explain how a particular service may be handled.

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