Breaking Through Credentialing Bottlenecks: Common Challenges and Proven Solutions
Credentialing shouldn’t feel like an obstacle course, but for many healthcare organizations, it’s exactly that—a maze of paperwork, compliance headaches, and unpredictable delays.
Each bottleneck creates obvious process inefficiencies, and if severe, these have broader implications for clinician onboarding, patient care, and even financial performance.
With Becker's healthcare conference around the corner, there’s no better time to determine what’s holding your credentialing process back—and more importantly, how to fix it.
Let’s unpack five of the most common bottlenecks organizations face and how Radiant’s expertise can facilitate real operational change.
1. Regulations and Licensing Issues
Navigating the complex web of state and federal regulations, payer-specific requirements, and accreditation standards is a time-intensive task.
Each state has its own medical licensing board with unique requirements, and while less specific, federal standards also impose overarching compliance rules on healthcare providers.
Missing or outdated documentation (or an inability to satisfy different timeframes and standards) can halt the process and leave healthcare organizations non-compliant.
The Impact
A single error can extend credentialing timelines by weeks, delaying clinician onboarding and disrupting patient care.
The Solution
Radiant’s automated compliance tools ensure all required documentation is collected, verified, and stored efficiently. Real-time alerts notify teams of expiring licenses or certifications to minimize delays and stay compliant.
2. Paperwork Overload
Despite the increased prevalence of automation, credentialing remains a predominantly manual, paper-based process for many organizations.
However, the extensive paperwork needed for licensure, certifications, and malpractice history causes various problems such as errors, duplicate work, and administrative burnout. Inconsistencies also erode the trust that is so critical in the healthcare industry.
The Impact
Administrative teams spend countless hours chasing documents and correcting mistakes, prolonging credentialing timelines and increasing frustration.
The Solution
Radiant’s use of KPI tracking and data-driven insights provides tools to identify bottlenecks, automate processes, and enhance efficiency—key strategies for tackling the paperwork-heavy nature of traditional credentialing workflows.
3. Vendor and Stakeholder Delays
Credentialing relies heavily on third-party entities like licensing boards, educational institutions, and providers. Yet, delays from these external stakeholders are common—particularly when there are documentation errors, seasonal spikes in requests, and inadequate staffing levels.
The Impact
Bottlenecks in stakeholder interactions lead to cascading delays that push onboarding schedules and create staffing gaps.
There can be severe financial consequences to these delays. In 2022 alone, for example, hospitals spent almost $20 billion trying to overturn denied claims from insurers. While 54% of hospitals were successful, many had to endure multiple rounds of costly, time-intensive appeals.
The Solution
Radiant streamlines these interactions with automated follow-ups and integrated communication tools. Our expert team of reimbursement specialists can also help you navigate the complexities of payer enrollment.
4. Lack of Standardized Processes Across Teams
Many organizations lack a unified approach to credentialing, with processes varying across departments and facilities. To some extent, this can be explained by a lack of standardization in credentialing itself.
There is no national system stipulating how hospitals must credential healthcare providers, nor is there one set of standards that healthcare professionals must meet.
This situation increases error rates and causes rejections that stall progress. Many teams also lack a fundamental understanding of their roles and responsibilities in the credentialing process.
The Impact
Teams waste time duplicating efforts or correcting misaligned workflows, further delaying clinician readiness.
The Solution
A standardized credentialing framework that promotes consistency across all teams and locations is key. With clearly defined workflows and role-specific task assignments, every employee (and indeed every department) understands what is required of them.
5. Inefficient Communication and Follow-Up
Credentialing involves multiple stakeholders, including clinicians, HR departments, relevant specialists, and external entities like licensing boards and payers.
Without clear and efficient communication, small tasks can quickly escalate into prolonged delays. Misaligned priorities, untracked follow-ups, and disorganized workflows can lead to unnecessary bottlenecks that disrupt otherwise efficient processes.
The Impact
Missed updates and unclear instructions cause unnecessary delays and frustrate physicians, making retention more challenging and disrupting patient care.
With the average physician generating around $2.3 million in annual revenue for a hospital, delays in onboarding due to poor communication also has a significant financial impact.
The Solution
Radiant’s credentialing solutions integrate automated notifications and real-time status updates. Teams and key stakeholders stay informed, and progress continues without the need for constant follow-ups.
Learn More at Becker’s 15th Annual Meeting
Ready to take control of credentialing bottlenecks?
Join Radiant at the upcoming Becker’s healthcare conference to discover how we can help you take control of your credentialing process. Our solutions remove inefficiencies, avoid administrative burdens, and facilitate a better overall experience for clinicians and staff alike.
If you can’t attend, why not download our whitepaper about the future of credentialing? There, we offer a sustainable path forward to help your organization reduce credentialing errors and other headaches.
References
https://www.aha.org/aha-center-health-innovation-market-scan/2024-04-02-payer-denial-tactics-how-confront-20-billion-problem
https://www.amnhealthcare.com/blog/physician/perm/new-survey-shows-physicians-are-key-revenue-generators-for-hospitals/
https://www.nccih.nih.gov/health/credentialing-licensing-and-education
