Why does credentialing take so long and cost so much?
Written by Joshua Kleinstreuer
Medical Credentialing is time-consuming and costly for everyone.
It can take weeks or even months to credential a provider. During that time, health professionals lose tens of thousands of dollars (or more) in lost income and facilities lose millions of dollars in revenue. This affects the industry-at-large, as it takes a multibillion-dollar hit.
To figure out why credentialing takes so long and costs so much, we decided to investigate.
Why it takes so long
Upon hiring, health professionals can’t start work at their new facility for anywhere between a few weeks to six months, due to credentialing.
On the provider’s end, the process only takes about three hours, as they submit around 20 different credentialing forms. For facility staff, credentialing takes about 20 hours per provider, as they complete several tasks, which may include:
- Initiate a background check
- Collect and verify credentials, clinical reputation and case history
- Collect and review claims, privileging and board history
- Check sanctions with the Office of Inspector General (OIG)
- Begin primary source verification such as American Medical Association (AMA), medical boards, and education history
- Present files to credentialing committees, executive committees, and facility stakeholders
- Establish a delineation of privileges and provide an appointment letter
Unfortunately, this process has to be done every time a provider is credentialed, with each facility collecting the same information. There’s little-to-no communication between the facilities and every place has their own way of doing it, creating a redundancy that delays the process even further.
There are a lot of other things that can delay the credentialing process, as well.
If anything’s missing from the provider’s application or an employer, school, or personal reference doesn’t respond quickly to verification requests, credentialing can take an additional few weeks or even months to complete. A lack of openings in the credentialing boards’ schedule can also delay the process, as can a provider dragging their feet or sending in incomplete or inaccurate information.
In other words, credentialing is a “mess that just gets worse and worse” and “takes many hours and causes many headaches,” according to author and physician Christopher Johnson, MD on KevinMD.
Why it costs so much
Slow credentialing costs providers, facilities, and the industry-at-large a lot of money.
It costs providers thousands in lost income—the exact amount of which depends on how much they make and how long it takes to get credentialed. For a physician making the average annual income of $299,000, waiting a few weeks would cost them around $25,000 in lost income, and waiting six months (worst-case scenario) would cost them around $150,000 in lost income.
Slow credentialing costs individual facilities a lot of money, as well. According to a Merritt Hawkins survey, a single physician earns a facility an average of $2,378,727 per year. If credentialing that physician takes a few weeks, the facility would lose around $150,000 in revenue. If it takes six months, that’s $1,189,363 in lost revenue for the facility.
This problem doesn’t only affect a few physicians and a few facilities, but it also affects the entire healthcare industry. As an Institute of Medicine study found, the United States wastes half of the estimated $361 billion a year it spends on healthcare administration. Of course, that administrative waste isn’t only on credential management, but slow credentialing still costs the industry billions of dollars a year on its own.
Imagine how much better patient care could be if that wasted money was reallocated toward buying better equipment, hiring more providers, and opening more facilities. This could lower wait times, improve patient satisfaction, and ultimately lead to a quicker, more accurate diagnosis.
A better way
Credentialing doesn’t have to cost this much money or take this long to complete.
With Intiva Health, it can be done in a matter of minutes, thanks to the company’s use of hashgraph. The way this technology works is that after credential documents are uploaded to the platform and verified, hashgraph creates a date and timestamp using a consensus algorithm. What this does is ensures the documents aren’t altered, providing the highest level of security out there.
The reason this speeds up the process is because it allows credentials to only have to be verified one time by only one facility instead of multiple times by every facility a provider works for. Now facilities won’t have to spend weeks or even months verifying something that’s already been verified, which is a huge time-and-money saver.
Expediting this process from weeks or months to minutes gets providers to work sooner, allowing them to earn money for themselves and for their facilities. Credentialing staff saves up to 20 hours per provider—time previously tied up in credentialing. And the industry-at-large saves billions of dollars a year.
Intiva Health also lets facilities do away with spreadsheets, which many use to keep up with expiring credentials. Now you just have to input the expiration dates into the platform and select when you’d like to receive email notifications of expiring credentials (you get to choose reminder dates of 30, 60, 90, and 120 days before the credential expires).
There are also time-saving features on the Intiva Health platform like OIG monitoring (which checks sanctions with a single click) and credential packaging (which puts all documents into a single folder that can be sent out).
All these features Intiva Health offers make faster credentialing entirely possible, which saves healthcare professionals, facilities, and the industry-as-a-whole a lot of time and money that can be reallocated toward patient care. To learn more, visit our provider credentialing software page.