For practice managers, healthcare providers, and clinic owners, timely follow-ups in provider credentialing are essential to reduce delays, protect revenue, and improve provider satisfaction. In fact, in today’s fast-paced healthcare landscape, credentialing is no longer just a back-office task—it’s a strategic priority that directly enables financial stability.
The average credentialing process takes 90 to 120 days, but lack of proactive communication can easily stretch this to six months or more. We will explore how consistent and structured follow-up can streamline your credentialing process, protect your practice from administrative failure, and keep your revenue cycle flowing smoothly.
1. Avoid Delays in Provider Onboarding (Accelerate Time-to-Revenue)
Credentialing involves multiple layers—license verification, education history, malpractice background checks, and multiple insurance payer approvals. Any delay in communication with these bodies pushes back a provider’s start date and revenue generation.
- Eliminate Bottlenecks: Timely follow-ups eliminate bottlenecks created by external entities (state boards, medical schools). For example, Primary Source Verification (PSV) relies on third parties responding to requests. Your follow-up ensures these entities do not forget the request.
- Revenue Impact: By proactively shortening the credentialing timeline, you accelerate the provider’s Time-to-Revenue (TTR). This directly helps your practice avoid the estimated $8,000–$15,000 in lost revenue per provider for every month of unnecessary delay.
2. Protect Your Revenue Cycle from “Silent Denials”
Until a provider is fully credentialed, they cannot bill insurance payers. This directly impacts your bottom line.
- The Silent Denial: Payers often lack the resources to proactively notify practices of missing documentation or a minor form error. Instead, they file the incomplete application in a “pending” status, creating a “silent denial.” Your file sits dormant until you call.
- Proactive Action: By staying proactive with licensing boards and insurance contacts, you prompt the payer to move the application forward. This shortens the credentialing timeline and allows your practice to start billing sooner.
3. Catch Problems Early (Prevent Administrative Crisis)
Small errors are inevitable, but timely follow-ups in provider credentialing prevent them from becoming major roadblocks.
- Identify Discrepancies: Regular follow-ups force the payer to review the file. This helps you identify and fix errors quickly, such as an incorrect NPI number, a missing signature, or an expired document copy, before they lead to a final rejection.
- Cost Savings: Researching and correcting a small error within one week of submission costs far less than correcting a final denial after three months.
4. Stay Compliant and Meet Deadlines
Payers and licensing boards operate on strict timelines. Diligent follow-up helps manage these external mandates.
- Submission Windows: Missing a submission window could mean restarting the process or losing temporary eligibility. Regular follow-ups allow you to confirm your submission met all initial criteria.
- Regulatory Status: Following up ensures your provider’s status remains compliant across your entire credentialing cycle, protecting your practice from fines and legal penalties associated with non-compliance.
5. Build Better Stakeholder Relationships
Credentialing involves working with people—at the payer’s office, the hospital, and the state board.
- Professionalism: Timely, respectful communication with credentialing teams, insurers, and boards fosters a reputation for professionalism. Over time, this improves collaboration.
- Faster Resolutions: Payer representatives are more likely to respond quickly and favorably to a practice known for organization and respectful communication, making future credentialing requests faster and easier to process.
6. Improve Provider Satisfaction and Retention
Providers want to feel supported, especially during the stressful onboarding process.
- Confidence and Morale: When you follow up regularly and keep the provider informed about their status (e.g., “We are now awaiting committee review”), they feel confident their onboarding is being handled efficiently. This transparency leads to improved morale and a stronger start to their tenure.
- Retention Link: Slow, chaotic onboarding is a top cause of provider dissatisfaction and early turnover. Efficient credentialing directly supports provider retention.
7. Stay Ahead of Regulatory Changes
Healthcare regulations change frequently, especially in credentialing. Your direct contact with payers provides vital intelligence.
- Adaptability: Regular check-ins with payers and licensing boards ensures your team stays informed about new forms, system changes (e.g., updated PECOS requirements), and policy shifts.
- Preparation: Knowledge is power. This external communication helps your team remain adaptable and prepared for the next wave of regulatory compliance.
The Proactive Protocol: Effective Follow-Up Tips
Implementing a structured follow-up protocol is essential for success.
- Use Credentialing Software: Automate follow-ups, track progress, and eliminate manual errors. Software provides a single dashboard to manage all payor timelines simultaneously.
- Keep Meticulous Records: Document every call, email, and submission. Log the date, time, contact name, and reference number for every interaction.
- Be Consistent, Not Pushy: Follow up professionally and regularly (e.g., every two weeks). Avoid aggressive communication, as this can antagonize representatives and lead to slower processing.
- Use Templates and Checklists: Streamline repetitive communication tasks with reusable, professional email templates and internal checklists.
Credentialing delays don’t just slow down onboarding—they hurt your revenue and your reputation. At eClinicAssist, we specialize in managing timely follow-ups in provider credentialing. We reduce administrative burden, ensure data integrity, and stay compliant with evolving payer and regulatory requirements.
Contact eClinicAssist today for a free consultation and see how we can support your credentialing process every step of the way.
