How Birches Health scaled from 10 providers in 2 states to 800 providers across all 50 states in under 3 years

Elliott Rapaport started Birches Health with a clear goal: build the largest national network of specialized providers for behavioral addiction treatment in the United States.

Not a regional network. Not a telehealth-only platform. A true national infrastructure with licensed, credentialed providers in every state, ready to see patients in person or virtually depending on clinical need.

The mission was urgent. Patients seeking addiction treatment often wait weeks or months for care, and provider networks are fragmented by state, payer, and licensing rules.

Birches started with 10 providers in 2 states. To reach national scale, it had to solve one problem first: credentialing and enrollment could not remain a manual bottleneck.

Where the process broke

Birches began with traditional credentialing and enrollment vendors.

The workflow was familiar: recruit a provider, collect credentials, send everything to the vendor, wait weeks for submission, then wait again for payer enrollment.

Applications sat in queues. Submissions went out with missing forms or incorrect information. Payers sent rejection notices.

Elliott watched qualified providers turn down offers because time-to-billing was too long. He watched markets stay closed because credentialing could not keep up with hiring.

"With legacy vendors, we constantly ran into issues where submissions were too slow or even just incorrect."

The core issue was not just speed. It was correctness.

In credentialing and enrollment, an application that does not go through the first time usually creates weeks of delay. Rework cycles can add 30 to 60 days. Denials mean starting over.

For Birches, that meant lost provider momentum, delayed market entry, and revenue that never had a chance to materialize.

Why Assured

Birches was not looking for a vendor that could handle the current workload. It was looking for infrastructure that could support what came next.

Most credentialing vendors are built for steady-state operations: maintain a fixed roster, add headcount as volume grows, and absorb complexity manually. That works at 50 or 100 providers. It breaks when the goal is national expansion.

Birches wanted to build a provider network, not a credentialing department.

Then Elliott evaluated Assured.

"We went with Assured because we thought they were the only company which would be able to take us from two states to 50 states and 10 providers to 800 providers."

That decision was about scale, but also about confidence: if the infrastructure could keep pace with recruiting, Birches could expand faster without adding operational drag.

What changed after Assured

Processing time dropped by up to 75%

Credentialing applications that once took weeks moved to days.

More importantly, the timeline became predictable. Birches could tell a recruited provider when they would be credentialed and enrolled, which made offer conversations easier and improved provider confidence.

"We're able to decrease processing times for each provider credential by up to 75%."

Enrollment denials fell to zero

Before Assured, Birches dealt with recurring rejections: wrong forms, missing attestations, incorrect payer portals.

After switching, denials dropped to zero.

Assured's system knew payer-specific requirements upfront. If Aetna needed a specific form or United required a wet signature, the platform flagged it before submission, not after rejection.

"Since Assured, our submission timelines have moved from weeks to days and more than that. We no longer see denials on credentialing applications because they're submitted correctly and on time."

Expansion moved ahead of plan

With credentialing and enrollment running smoothly, Birches could open markets faster.

Markets that were supposed to open later were ready sooner.

"The combination of corporate team members internally and our partner Assured meant that we saw economies of scale and we were able to pull in network care forward and enter over 10 new markets a quarter before we had originally expected to."

That was not incremental improvement. It was the growth plan moving forward.

The compounding effect

Once credentialing stopped being the bottleneck, the rest of the business moved faster.

Birches could hire faster because recruits knew they would start seeing patients in days, not months.

Birches could enter new states faster because multi-state licensing and enrollment that used to take months now took weeks.

Birches could retain providers better because nobody wants to wait 90 days sitting idle on paperwork.

Birches could generate revenue faster because every week a provider sat unenrolled was a week of lost billing.

The operational gains compounded into strategic advantage.

Within three years, Birches grew from 10 providers in 2 states to 800 providers across all 50 states.

It became the largest national network of specialized providers for behavioral addiction in the United States.

"In direct partnership with Assured, Birches Health has scaled to all 50 states and submitted thousands of credentialing applications to build the largest national network of specialized providers for behavioral addiction."

Why it mattered for patients

Birches is a mission-driven company. Its growth is not only about operational efficiency; it is about access.

Patients cannot wait months for care. Providers are scarce. Payer panels open and close quickly. If the infrastructure is slow, the mission stalls.

"At Birches Health, we are ensuring the highest quality clinical outcomes for patients. What we care about is creating a patient and provider experience that leads to the best possible treatment."

For Birches, credentialing was the mechanism that helped patients get care sooner.

Outcome