Physicians lose the most from provider credentialing delays

Months-long average provider credentialing delays are leading to lost revenue, according to new data from the healthcare credentialing site Assured.

The data emailed to Informa TechTarget's Rev Cycle Management shows an average delay of 90 to 120 days for provider credentialing. Based on average salary data of healthcare professionals from the U.S. Bureau of Labor Statistics, this delay in provider credentialing is leading to up to hundreds of thousands of lost revenues for physicians.

Physicians and surgeons topped the list of healthcare professions with the greatest monetary loss from provider credentialing delays, Assured reported. These types of providers lost up to $122,144 during the 120-day period because of credentialing delays. This was based on the average salary of $239,200.

Dentists and podiatrists rounded out the top three healthcare professions with the greatest monetary loss from provider credentialing, losing up to $87,274 and $72,332, respectively. Dentists earned an average salary of $170,910 and podiatrists earned an average of $141,650, based on the Bureau of Labor Statistics data.

Other healthcare professions making the top ten included pharmacists ($69,462), medical dosimetrists ($67,854), optometrists ($67,333), physician assistants ($66,394), veterinarians ($60,817) and physical therapists ($50,916).

The data also analyzed monetary losses during a 120-day period for nurse anesthetists, nurse midwives and nurse practitioners, who stand to lose up to $66,118.

Provider credentialing is a complex process for verifying a provider's qualifications, including education, licensure and clinical experience before they can deliver care to patients within a facility. This process is key to enrolling providers and making them eligible for reimbursement from payer partners.

However, the process can be tedious when organizations have to credential and enroll providers across every payer partner, leading to duplicative and often manual work for administrative staff.

“Credentialing delays have been holding healthcare professionals back for years, and now we know just how much it’s costing them—especially doctors, dentists, and podiatrists," CEO and co-founder of Assured Varun Krishnamurthy, said in an emailed statement.

“Physicians and surgeons can lose as much as $122,144 while waiting to get credentialed, and it’s not just their bank accounts taking a hit," he continued. "These delays worsen staffing shortages, putting even more strain on an already overwhelmed healthcare system.”

Jacqueline LaPointe is a graduate of Brandeis University and King's College London. She has been writing about healthcare finance and revenue cycle management since 2016.