Credentialing isn’t just paperwork. It controls access. It affects patient care. It touches every part of the provider pipeline. Even now, with better systems and smarter tech, credentialing still drags. Backlogs pile up. Hospitals lose revenue. Clinics stay short-staffed. So, why is this still happening?
It’s not about one cause. It’s about layers of slow systems, missing data, and old thinking. We’ve worked with medical teams across roles. We’ve seen the pressure. We’ve seen the burnout. That’s why we build better ways to manage credentialing for modern teams.
Here’s what keeps the problem alive—and what needs to change.
Credentialing still relies on fragmented sources. One license check goes to a state board. Another goes to a school. Background checks come from another source. Then there’s malpractice history, peer references, and hospital privileges. All these parts don’t talk to each other. That’s the first roadblock.
Some offices still fax documents. Others rely on emailed PDFs. Each file waits for manual review. A mistake in one form means a reset. Providers fill out the same info again and again for every facility. There’s no central identity. No standard.
That slows everything down. And this isn’t rare. A 2023 survey from the Council for Affordable Quality Healthcare found that 74% of providers still report redundant credentialing steps across networks. This wastes time and energy
Time lost isn’t just time lost. It’s revenue gone. Each day a provider waits for credentials, care gets delayed. Revenue sits idle. Teams get stretched. Patients get rescheduled or sent elsewhere. Credentialing delays can cost large health systems millions every year.
It’s not just about waiting—it creates long-term losses:
For smaller practices, even one delay is a hit. In group settings, the delay of one doctor can slow down the whole unit.
Hospitals have started calculating these losses in daily rates. One health system pegged the cost of onboarding delays at over $7,500 per day, per physician. That’s a steep bill just for waiting.
Some hospitals still use systems built over a decade ago. They weren’t made for today’s compliance needs. They can’t handle real-time updates. They don’t integrate easily. That means credentialing teams have to work around them. They keep spreadsheets. They check status manually. Updates get tracked across multiple systems that never match. Even larger groups that move to digital often end up with half-finished transitions. A new interface on top doesn’t solve the core issue.
We’ve helped several clinics move away from this pattern. They didn’t need more dashboards. They needed one system that cut through the noise and worked with their real process—not against it. This is where a modern healthcare credentialing software solution can make a difference. It builds the system around actual daily workflows, not old assumptions.
Credentialing used to be about verification. Now it’s about risk management. Regulators expect more. Audits go deeper. Every step of the process needs to be logged, stored, and easy to show. State rules change often. Insurance requirements change too. That puts pressure on teams to keep up. When tools don’t update fast, compliance risk grows.
That leads to:
Credentialing is now tied to provider enrollment and reimbursement. If credentialing lags, billing gets held up. That means more financial pressure. We’ve seen clinics where one small compliance error froze payouts for months. That kind of backlog creates real damage—not just admin stress.
Credentialing teams are often small. Many rely on just one or two staff to manage the entire process. Turnover hits hard. It takes time to train new staff. Processes live in people’s heads. If the credentialing coordinator leaves, everything slows down. Sometimes, credentialing has to be redone from scratch.
In some hospitals, we found that no formal documentation existed. That meant delays every time someone new came on board. Standardizing this work is key. But standardizing doesn’t mean more templates. It means building a system where tasks, progress, and deadlines are clear—no matter who’s managing the file.
A good healthcare credentialing software does this behind the scenes. It tracks steps. It sends alerts. It reduces the learning curve for new team members.
Every payer has its own process. Its own forms. Its own requirements. That means providers need to go through credentialing multiple times—for each payer, for each state, and often for each plan. One insurer may take weeks to respond. Another may send back a request for clarification. That restarts the clock.
Credentialing delays are often blamed on providers. But in many cases, the wait is on the payer’s side. Without smart tracking, there’s no way to see where the delay is. That leaves administrators chasing emails and leaving voicemails just to check status.
This is one of the top reasons groups switch to automated credentialing platforms. Tracking timelines and responses should never be a manual job.
Credentialing is often viewed as a cost center. It’s seen as support work. That mindset keeps the process stuck. In many clinics, credentialing only gets attention when something breaks.
That leads to:
It also means credentialing is often siloed. It doesn’t get looped into growth planning or staffing strategy. That hurts the whole practice. Forward-thinking clinics treat credentialing as a growth enabler. They invest in it. They build systems that scale.
That’s the approach we take. We design tools that support growth, not just compliance.
Credentialing will always be complex. But it doesn’t have to be slow. The answer isn’t to add more hands. It’s to create smarter systems. Automation helps—but only if it’s tied to actual workflows. Integration helps—but only if it removes double entry. What matters is making credentialing visible, trackable, and simple to manage across teams.
That’s how we build. We create software that fits healthcare, not the other way around. Credentialing should support care. Not slow it down. Apex Custom Software builds healthcare software with real teams in mind. We solve for complexity without adding clutter. Our goal is to eliminate backlogs, not just manage them.