Industry Update
Credentialing Timelines Are Getting Longer
Plan enrollment as a lead time, not a task. It has consequences for hiring.
Credentialing has been getting slower. Applications sit longer, more are returned for missing information, and effective dates increasingly land well after a provider's start date.
The financial effect is easy to underestimate. A provider who starts before enrollment completes is seeing patients whose claims cannot be submitted. Depending on the payer, those claims may be billable retroactively to the effective date — or they may not be billable at all.
Two things help. First, treat credentialing as a lead time in hiring rather than an administrative task after it: start the application when the offer is signed, not when the provider arrives. Second, know each payer's retroactive billing policy in advance, so you can decide what that provider's first weeks should look like rather than discovering the answer afterwards.
Neither speeds the payer up. Both stop the delay turning into unbillable work.