Automating physician credentialing: Accelerating turnaround while minimizing costs, errors, and non-compliance

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The traditional physician credentialing process is long and arduous, taking anywhere between 60 to 90 days, given the level of diligence required when appointing front-line healthcare service providers. Reviewing lengthy applications, conducting background checks, validating licenses and certifications, cross-checking peer references – all of it takes time but is critical to maintaining quality and managing risk. Providers incur a whopping $7000 per application, in addition to 20 hours of administrative time.1

And, if the credentialing team members encounter missing or incorrect information, they will need to conduct additional outreach, increasing costs and extending the timelines further.

While the long cycle time posed significant challenges even prior to the pandemic, the need to rapidly onboard credentialed physicians in its wake has created a sense of urgency around automating the process.

Manual vs automated credentialing: Striking the right balance

Manual credentialing verification requires the support of a dedicated full-time credentialing team – filling out hundreds of pages of paperwork, chasing down people for signatures, reaching out to various organizations for information, faxing data to other institutions, and so on (see Figure 1). Relying on outdated credentialing software and archaic systems that rely on Excel sheets, post-it notes, and filing cabinets, creates major impediments to healthcare organizations’ ability to cater to changing patient needs and grow revenues. All the more so when patient expectations for accessible and quality care are growing by the day, even as COVID continues to impact the healthcare industry in unprecedented ways.

Figure 1: Manual credentialing

What Providers need is an autom