The problem
Credentialing rarely fails because it's hard. It fails because nobody has time to chase it.
The person who owns it has a dozen other jobs. So almost every file runs the same loop.
- 1StartedA new hire's file gets opened. Everyone means well.
- 2StalledA payer goes quiet. A provider forgets a document. Nobody notices for weeks.
- 3ChasedSomeone finally spots it and starts sending reminders. Now you're the one chasing people.
- 4LostYour coordinator moves on. Half the file lived in their inbox.
- 5RestartedYou hire someone new, train them for months, and the file starts over.
And the next new hire's file starts the same loop. Meanwhile, a clinician who is ready to see patients waits months to bill, and the providers you already have drift out of date one renewal at a time.
We added 80 providers last quarter and our team of 6 is drowning in CAQH attestations and renewals. We're losing clinicians to competitors who onboard faster.
Optum demanded delegated-credentialing documentation and we're not NCQA compliant. We're rebuilding files from scratch and it's costing us six figures.
Real quotes from first calls, paraphrased and shared with permission.
In one sentenceThe work isn't the problem; the follow-up nobody has time to make is.