Upstate Healthcare Administration

Upstate Healthcare Administration is a Rochester, NY-based medical billing and credentialing service built for solo therapy providers and small group practices across the United States. Where most billing vendors hand off applications to a team clients never speak to, this practice runs differently. Danielle Wagar, a Certified Provider Enrollment Specialist with over 15 years in medical billing, revenue cycle management, and provider credentialing, handles every engagement personally. For practices that need reliable healthcare back-office outsourcing without losing visibility, that distinction matters. The service offering covers the full credentialing and billing lifecycle. Individual credentialing runs $200 to $250 per payer and includes CAQH setup, payer applications, enrollment tracking, and EFT and ERA guidance so practices are set up to receive payments from day one. Group credentialing for multi-provider practices starts at $1,500 and covers provider roster linking and payer setup across all enrolled providers. For practices starting from scratch, the Full Startup Package at $1,299 bundles individual credentialing for up to five payers with complete EMR configuration on either Jane App or SimplePractice. Ongoing billing support starts at $350 per month for solo practices and $750 per month for small groups of one to four providers, covering claim submission, payment posting, denial management, accounts receivable, and monthly performance reporting. The client base is focused on outpatient therapy and behavioral health: mental health and psychiatry, physical therapy, occupational therapy, and speech-language pathology. Of the 29 practices currently served across 11 states and 62 payers, 17 are behavioral health. Medicaid enrollment has been completed across five states, each with its own portal requirements. The typical client is a solo provider or small group navigating insurance panels for the first time or rebuilding after credentialing delays. What separates this operation from larger outsourcing providers is follow-up discipline. Credentialing applications stall not because payers say no, but because nobody calls to check. Every application carries a follow-up date and a reference number, and clients get portal access to see exactly where each one stands. Commercial credentialing timelines commonly run 90 to 150 days; that expectation is set upfront. Closed panels, mismatched taxonomy codes, and incomplete application packets are caught before submission rather than discovered after a denial. Therapy practices looking to outsource healthcare billing and credentialing can request a free 15-minute consultation through the website to discuss their current enrollment situation and get a straight answer on what is feasible.