Fixing Credentialing Bottlenecks: What Every Hospital Leader Needs to Know
By: Guy Miceli, CEO Radiant Healthcare
Credentialing delays aren’t just a frustrating inconvenience—they’re a major operational challenge. They slow clinician onboarding, drain resources, and cost hospitals revenue every single day.
For leaders juggling tight budgets and high patient volumes, ignoring credentialing inefficiencies is no longer feasible.
After 25 years in healthcare operations, experience tells me that the best solutions are straightforward, practical, and built to produce results.
With that in mind, let’s guide you through fixing credentialing bottlenecks by leveraging technology and getting teams onboarded faster.
Why Credentialing Problems Deserve Your Attention
Credentialing tends to be seen as tedious and cumbersome, but it directly impacts your hospital’s performance.
Leaders can’t afford to overlook credentialing-related issues—particularly those in large health systems where the implications for financial performance and patient safety are more severe.
Revenue loss
Each day a physician cannot work due to credentialing delays means missed billing opportunities. According to one survey, each day physician onboarding is delayed costs a medical group $10,122.
Strained workforce
When onboarding slows, existing teams pick up the slack, leading to burnout and turnover. It’s a cycle hospitals can’t afford to perpetuate.
Compliance risks
Errors or missed deadlines in credentialing expose hospitals to audits, fines, and reputational damage with accrediting bodies and the general public.
Credentialing inefficiencies are more than an operational headache. They’re holding your hospital back from its full potential.
Technology, and What it Means for Credentialing
Traditional credentialing processes are no longer sustainable, and hospitals that rely on manual workflows and paper files are falling behind.
The solution?
Technology that simplifies, accelerates, and improves the entire process.
Here’s how modern tools make life easier:
Digital document management. Electronic systems store all provider data in one secure, searchable location. No more time wasted sifting through documents.
Real-time verification. Automated systems instantly check credentials against national databases, cutting what used to take weeks down to a matter of hours.
Continuous monitoring. Credentialing doesn’t stop at onboarding. Automated tools track license statuses and send real-time alerts for expirations, for example. Nothing slips through the cracks.
These technologies have obvious benefits for efficiency, but they also make credentialing more accurate and compliant. What’s more, robust credentialing processes are a fundamental aspect of maintaining patient safety and healthcare quality.
Practical Steps for a Streamlined Credentialing Process
Transforming your credentialing process doesn’t require a complete system overhaul. Instead, focus on these small actions that deliver real results.
Audit the current workflow
Identify bottlenecks and inefficiencies. Is the holdup in document collection, verification, or communication?
Knowing the problem is the first step to solving it.
Centralize credentialing operations
Consolidating tasks into a single platform eliminates data entry duplication and ensures consistency. Hospitals that centralize workflows often discover they can cut processing times by as much as half.
Adopt automation
Automating repetitive tasks like license verification reduces errors and administrative strain. Your team can focus on higher-value activities instead of chasing paperwork.
Interested in learning more? The benefits automation brings to credentialing are explained later in the article.
Train your credentialing team
Even the best tools won’t work without the right expertise. Invest in training so your staff can fully leverage the technology and analytics at their disposal.
Measure success with KPIs
Track metrics like time-to-credential, first-pass approval rates, and error reduction to monitor progress and stay accountable.
These steps are practical, proven, and designed to get results without overcomplicating the process.
How AI Fixes Credentialing Inefficiencies
Artificial intelligence (AI) is a practical, results-driven solution to the bottlenecks hospitals face in credentialing.
Traditional processes are too slow, too error-prone, and too resource-intensive to keep up with today's demands. But AI isn't here to replace your personnel. Instead, think of it as a way to make staff more efficient and accurate.
Smarter workflow management
AI tools dynamically prioritize tasks to help your team tackle the most urgent issues first—like licenses nearing expiration or incomplete applications. This keeps the credentialing process moving forward without unnecessary delays.
With 17% of revenue denials caused by avoidable issues, AI offers a tremendous opportunity to streamline revenue cycle management and improve oversight.
Precision data matching
Unlike manual systems, AI understands the context behind data. This means it can reduce false positives, connect the dots with precision and speed, and streamline verification.
For example, an AI tool could detect that a physician listed as “Dr. John A. Smith” in one database and “J. Smith, MD” in another refers to the same individual. To do this, it would cross-check supporting details like birthdate, license number, and work history.
Proactive risk identification
AI is proactive in the sense that it identifies future problems. With predictive analytics, teams can address delays or compliance risks before they escalate.
Artificial intelligence can flag providers likely to miss deadlines based on previous behavior, for instance, allowing administrators to avoid inefficiency.
Process transparency
One of the biggest benefits of AI is transparency. Real-time dashboards and audit trails give organizations a clear view of the entire credentialing process, so there’s no confusion about where things stand.
This level of transparency builds trust among administrators, clinicians, and leadership. It also reinforces confidence that the hospital is operating at its maximum potential.
Ready to Take Action?
Credentialing shouldn’t slow you down. Radiant’s white paper breaks down CCV complexities and explains how the process differs from payer enrollment. We also emphasize the increasingly important role AI has to play.
Discover how Radiant streamlines labor-intensive processes, improves compliance and cuts onboarding times—all while lowering costs and reducing errors.
The time to act is now—don’t let bottlenecks hold your team back.
Learn how to tackle bottlenecks and reduce operational headaches with actionable tips and AI technology in Radiant’s latest white paper.
References
https://www.mgma.com/mgma-stats/more-than-half-of-practices-report-credentialing-related-denials-on-the-rise-in-2021
https://assets.ctfassets.net/cd2ivy5nzajd/4xmplSPppP5Iseqs1S5Uwc/194fda7074b8750b8d330962e1067b85/PLJ_SepOct_2024_37-40.pdf
https://www.beckershospitalreview.com/finance/physician-practices-losing-nearly-250k-annually-survey.html
