Practical Steps to Streamline the Process and Avoid Costly Delays
Credentialing is one of the most important and time-sensitive steps in onboarding a new provider, and it plays a critical role in the success of any health care practice.
Credentialing ensures providers are properly verified, contracted, and approved to deliver care while protecting your clinic from compliance issues and reimbursement delays. Without complete and accurate credentialing, providers cannot see patients under insurance plans, which directly impacts clinic revenue, scheduling capacity, and patient satisfaction. A well-managed credentialing process supports smooth onboarding, maintains payer relationships, and helps your practice operate with confidence and efficiency.
On average, the process can take anywhere from 30 to 180 days, depending on payer requirements, documentation accuracy, and how quickly information is submitted. The timeline can feel long, but the good news is that many delays are completely avoidable.
With a proactive approach, your clinic can keep credentialing moving, reduce frustration for both providers and staff, and ensure your team is ready to deliver patient care without unnecessary setbacks.
1. Know Your Credentialing Essentials
Preparation is the foundation of a smooth credentialing process. The more complete and accurate your information is at the start, the faster payers can review and approve the application.
Make sure you collect and verify all of the following:
- Council for Affordable Quality Healthcare (CAQH) profile
- Personal demographics
- National Provider Identifier (NPI)
- State license information
- Professional Liability Insurance (PLI)
- Education information
- Employment history
- Peer references
- Group demographics
Having these items ready, current, and organized shortens review times and minimizes back-and-forth communication that slows the process.
2. Avoid the Most Common Delays
Many credentialing delays stem from small errors that snowball into major setbacks. Understanding these issues helps your team prevent them before they occur.
Frequent causes of delays include:
- Missing or incomplete documents
- Submitting incorrect information
- Documents expiring within 30 days of submission
- A CAQH profile that is outdated or not attested
3. Keep Credentialing on Track
A successful credentialing process depends not only on consistent follow-through but also timely communication across all stakeholders. These simple habits can make a significant difference in making your process more efficient, streamlined, and easier to manage over time:
- Submit requests as soon as possible. (If something changes with the status of the provider, you can submit a request to cancel the original submission.)
- Take time to gather and verify the correct information.
- Obtain copies of all current documentation before submitting.
- Set reminders for follow-ups so deadlines do not slip through the cracks.
- Respond quickly to all payer requests and questions. (Remember that requests can be cancelled if they sit too long.)
These steps reinforce your ability to control the timeline and ensure important details do not get overlooked.
Credentialing is a detailed, multistep process, but with the right preparation and follow-up, your clinic can stay ahead of common delays and get providers credentialed as efficiently as possible.
If credentialing feels overwhelming or you simply do not have the time to manage the process for your team, Audigy can help.
Learn more about our back-office solutions