Case StudyDigital Health·Hybrid RPO

How a teletherapy platform took on 3× more therapist applications with the same team of two.

A therapy marketplace had more licensed clinicians wanting to join than it could get through the paperwork. Skillfi split the work: US recruiters handled sourcing and first conversations, and an offshore team took on licence checks, documents and payer enrolment. It's the hybrid model in our RPO solutions.

Applications a month
180→540
2Same internal team
26 daysOffer to first session
190Therapists onboarded
01

Therapists wanted to join. The paperwork kept them waiting.

The platform connects clients with licensed therapists by video across 22 states. Client demand was growing faster than provider supply, and several states had waitlists of a month or more.

Applications weren't the problem. A provider operations team of two was handling recruiting calls, state licence checks, document chasing and insurance enrolment for every therapist. Applications piled up, and approved therapists often signed with another platform while they waited.

58 daysfrom offer to first session
400+applications in the backlog
1 in 3approved therapists dropped out

Good therapists wanted to work with us. We just couldn't get through the paperwork fast enough to let them.

Head of Provider Operations, client
02

Conversations in the US, paperwork offshore.

Skillfi mapped every step from application to first session and split it by what needs a person in the US and what can be done remotely. Clinical decisions stayed with the client's clinical lead throughout.

Source

US recruiters for the first conversation

Sourcing by state and specialty, intro calls on caseload and schedule, then a clinical interview booked with the client's clinical lead.

Verify

An offshore credentialing team

State licence and disciplinary checks, NPI, malpractice insurance, references and a complete CAQH profile for every therapist.

Enrol

Payer enrolment, tracked to the end

Insurance applications submitted and followed up weekly, with one shared tracker showing where every therapist stood.

The Engagement

9 months, two teams

From a backlog of applications to a steady flow of therapists going live. Here's how the engagement unfolded.

  1. Month 1

    Process mapping

    Every step from application to first session listed, timed and assigned to the US or the offshore team.

    14 steps mapped
  2. Month 1–2

    Offshore team trained

    Five credentialing specialists trained on state board lookups, CAQH and the main payer portals.

    5 specialists
  3. Month 2

    US sourcing live

    Two US recruiters on outreach and intro calls, focused on the states with the longest waitlists.

    4 licence types
  4. Month 3–4

    Backlog cleared

    One shared tracker and a daily handoff between teams worked through the waiting applications.

    400+ cleared
  5. Month 5–8

    New state launches

    Therapists licensed in Texas and Georgia sourced and enrolled ahead of the platform's launch in both states.

    2 states
  6. Month 9

    Steady state

    Three times the monthly applications processed, with the same two people on the client's provider team.

    540 a month
Inside the Credentialing Pipeline

From application to first session in four stages

Most delays came from work waiting between people. Running US and offshore steps side by side meant a therapist's file kept moving day and night.

USDays 1–5

Find & screen

  • Sourcing by state & specialty
  • Intro call & caseload fit
  • Clinical interview booked
OffshoreDays 3–10

Verify

  • Licence & disciplinary checks
  • NPI, insurance & references
  • CAQH profile completed
OffshoreDays 8–20

Enrol

  • Payer applications submitted
  • Weekly payer follow-ups
  • Contracts & tax forms
USDays 18–26

Go live

  • Platform profile & bio
  • Orientation session
  • First client matched
Day 26–90: Early activity checksShort check-ins flag therapists with low caseloads or admin problems before they quietly stop taking clients.
Day 30 · Caseload check Day 60 · Feedback call Day 90 · Active provider
The Results

What changed in nine months

Days from offer to first session

Team of two doing it all58 days
US + offshore hybrid26 days
015304560

Median across all therapists onboarded during the engagement.

Applications processed a month180→540
Therapists onboarded—→190
Approved therapists lost before first session1 in 3→1 in 9
Waitlist in Texas & Georgia4–6 wks→<1 wk
Internal provider ops team2→2
PO

My team now spends its time talking to therapists instead of chasing forms. We handle three times the applications and haven't had to add anyone in-house.

Head of Provider Operations, client
Your Turn

Providers ready to join, but stuck in paperwork?

Our RPO team pairs US recruiters with an offshore credentialing team, so licensed providers go live in weeks rather than months. Only need help finding specialists? Our fractional recruiter team can fill the gaps.

What we'd build for you
  • US sourcing & first screening
  • Licence & document verification
  • Payer enrolment tracking
  • 30/60/90-day activity checks
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