Credentialing Delays: The Silent Threat to Patient Care and Revenue
Clinician credentialing is a vital process for ensuring healthcare organizations meet compliance requirements and deliver safe patient care. However, inefficiencies in this process often go unnoticed until their consequences disrupt operations.
The hidden costs of poor credentialing are not limited to administrative delays and missed deadlines—they jeopardize patient outcomes, erode trust within the system, and cost the industry over $1 billion each year in lost revenue.
Let’s explore these overlooked costs and why addressing inefficiencies is critical for modern healthcare organizations.
Financial Losses Beyond Revenue
Credentialing delays have a direct impact on revenue, with each day of delay impacting billable hours and reducing the number of patient appointments.
However, financial losses may also be incurred in other, less obvious areas.
Administrative Overhead
Without automated processes, staff spend untold hours (perhaps in the order of 20-40 hours per week) on manual tasks and drive up operational costs in the process. These inefficiencies often necessitate overtime pay or the recruitment of temporary staff, further straining budgets.
Missed Billing Opportunities
Incomplete credentialing can lead to billing delays or denials—especially for clinicians involved in government programs like Medicare.
Organizations then face the added burden of appealing denied claims, which consumes more resources and extends cash flow interruptions.
Recruitment and Retention Costs
Delays in onboarding due to credentialing inefficiencies frustrate clinicians and can lead to turnover— especially for locum tenens clinicians, specialists in high-demand fields, and new graduates.
Often, the cost of recruiting and training replacements outweighs the expense of just improving credentialing workflows. Indeed, according to the Society for Human Resource Management, it can cost organizations up to 200% of an employee’s annual salary to replace a specialized healthcare professional.
Risk Amplification in Compliance
Inaccurate or incomplete credentialing introduces compliance risks that can lead to substantial penalties and reputational harm.
These include:
Regulatory fines. Healthcare organizations are subject to stringent requirements, and errors in credentialing can result in fines or lawsuits.
Loss of accreditation. Institutions that fail to meet credentialing performance standards risk losing their accreditation.
Increased audit scrutiny. Inefficient credentialing can trigger audits and create additional administrative burdens and fines if discrepancies are uncovered.
Operational Strain and Administrative Burden
Credentialing inefficiencies don’t just create financial headaches—they also place undue strain on already burdened administrative teams.
Manual workflows often lead to:
Backlogs and errors. When credentialing teams are overwhelmed, mistakes are more likely. Missing documentation, incorrect data entry, and miscommunications are common issues that delay processes and compound inefficiencies.
Diverted resources. When staff spend more time managing credentialing tasks, they have less capacity to focus on strategic priorities like improving patient care systems or addressing staffing needs.
Hidden Consequences for Patient Care
Patients are rarely aware of the credentialing processes behind the scenes, but they feel the effects when things go wrong.
Inefficient credentialing disrupts care delivery in several ways that aren’t immediately obvious:
Staff shortages. Delays in onboarding clinicians leave gaps in care teams, which forces existing staff to take on more work. One study found that 63% of physicians experience burnout weekly, with inefficiency in the healthcare system an oft-cited driver.
Delayed access to specialists. In fields like oncology or surgery—where specialists are critical—credentialing delays can result in postponed procedures and negatively impact patient outcomes.
Erosion of trust. Patients expect their healthcare providers to run efficiently. Delays, canceled appointments, and inconsistent care from different individuals erode trust and make it harder for organizations to retain their patient base.
Radiant Healthcare: A Solution for Hidden Costs
Radiant Healthcare’s approach to credentialing is not limited to fixing surface-level inefficiencies—it addresses the deeper problems that often go unnoticed.
By leveraging technology and expertise, Radiant ensures healthcare organizations can minimize financial risks, maintain compliance, and focus on delivering exceptional care.
In our white paper, we explain how Radiant helped an allied health and nurse staffing agency firm hit 98% compliance for 12 consecutive months. In another case study, we detail how Radiant established a team of 150 credentialing specialists to help a leading healthcare agency reduce labor costs by almost 40%.
To explore these success stories in detail and learn how to mitigate the hidden costs of credentialing inefficiencies, download Radiant Healthcare’s whitepaper today.
References
https://prognocis.com/the-importance-of-medical-credentialing-roi
https://hitconsultant.net/2019/11/15/inaccurate-provider-directories-costs-physician-practices-2-76b-annually/
https://pmc.ncbi.nlm.nih.gov/articles/PMC10773242/
https://www.oracle.com/za/human-capital-management/cost-employee-turnover-healthcare/
