The Credentialing Wake-Up Call: How Slow Processes Quietly Drain Millions Every Year
By Halena Pill 13-11-2025 97
Why is medical credentialing still one of the slowest processes in modern healthcare operations? Approximately 54% of medical practices report denials related to provider credentialing have increased thus far in 2021, while 41% say they have stayed the same, and only 5% note these denials have decreased this year.
In healthcare, accuracy and speed aren’t just important; they’re essential. Every moment matters, yet one critical administrative step still drags on endlessly in many organizations' provider credentialing. It’s often dismissed as background paperwork, but these delays quietly cost hospitals, clinics, and health systems millions annually.
Let’s take a closer look at how this hidden money drain happens, how it impacts patients, and why healthcare leaders can’t afford to keep delaying the modernization of credentialing workflows.
The Hidden Price of Credentialing Delays: How Every Day Lost Costs Real Money
When a new provider joins a hospital or medical group, they can’t legally see patients or bill insurers until they are fully credentialed and enrolled with payers. This process, on average, can take 60 to 120 days, sometimes even longer, depending on state laws, payer response times, and internal inefficiencies.
Now imagine this:
A single physician could generate between $30,000 and $50,000 per month in billable services. If credentialing delays hold up their start date by three months, that’s a potential loss of $90,000 to $150,000 per provider, and that’s just the direct revenue loss. Multiply that by dozens of providers, and it’s easy to see how a large healthcare organization could lose millions annually simply due to credentialing backlogs.
And this doesn’t account for the hidden ripple effects of increased workload on existing staff, patient waitlist extensions, and lost referral opportunities.
Why Credentialing Keeps Getting More Complicated
Credentialing isn’t just another administrative step; it’s what protects patients and healthcare organizations from serious risks. It makes sure every provider is fully qualified, licensed, and following both state and federal healthcare rules.
Agencies like the Centers for Medicare & Medicaid Services (CMS) and the Joint Commission require strict credentialing steps before a provider or facility can take part in their programs or earn accreditation.
Across the U.S., credentialing follows strict steps to verify a provider’s background, from education and board certifications to past employment and malpractice records. If these standards aren’t met, organizations risk fines, denied payments, and even legal trouble.
Therefore, these rules also make credentialing a complex process, with countless databases to check, documents to verify, and insurers to update. Yet many organizations still depend on spreadsheets and paper files, outdated methods built for the 1990s that can’t keep up with today’s workload.
The Hidden Cost of Slow Credentialing
According to a 2024 MGMA survey, 78% of healthcare leaders said onboarding and credentialing delays are one of their biggest operational headaches.
When providers can’t start seeing patients because the credentialing process takes too long, appointment wait times grow, especially in high-demand areas like mental health, primary care, and cardiology.
Some practices even had to turn away new patients or postpone opening clinics because uncredentialed providers couldn’t bill insurers.
Impact of Slow Credentialing on Revenue
A slow credentialing process doesn’t just create operational headaches; it hits a healthcare organization’s revenue hard. When providers aren’t credentialed on time, they can’t bill insurers for their services, which puts revenue on hold.
These delays ripple through the organization: administrative staff spend extra hours tracking paperwork and filing claims by hand, while new patients often have to wait longer for appointments. Over time, these inefficiencies add up, quietly costing healthcare organizations millions across multiple providers.
Below are some of the key Impacts of Credentialing Delays on Revenue:
- Providers who aren’t credentialed on time can’t bill insurers, which slows down payments.
- Each delayed provider translates to real revenue lost for the organization.
- Staff spend extra hours managing paperwork, increasing costs and workload.
- Bottlenecks in the process can make patients wait longer for appointments.
- Across multiple providers, slow credentialing quietly adds up to millions in lost revenue every year.
How to Speed up Provider Credentialing
Partnering with specialized teams through outsourcing isn’t just an option; it’s a game-changer for providers. These experts handle the tedious, time-consuming tasks like checking education, board certifications, and work history quickly and accurately.
By letting go of these steps, healthcare organizations can cut down credentialing inefficiency, stay fully compliant with healthcare regulations, and free their in-house team to focus on what truly matters: giving patients the care they need.
Don’t let slow processes hold you back. Take charge of your medical credentialing today. Get your providers seeing patients faster, streamline workflows, cut delays, and start boosting revenue while improving patient access.
The sooner you tackle the process, the sooner your organization can run at full speed and reach its full potential.
Take Control of Your Medical Credentialing Today
The healthcare industry can no longer ignore the hidden cost of outdated credentialing workflows. Slow medical credentialing doesn’t just create paperwork; it delays revenue, keeps patients waiting, and adds stress to your staff.
Every day of postponed provider credentialing means lost revenue and missed opportunities for patient care. By upgrading the credentialing process with the support of outsourcing, healthcare organizations can accelerate provider onboarding and ensure patients receive timely care. So don’t wait up, make credentialing a top priority today, and keep your organization running at full speed.
