The credentialing process between payers and providers is one of the most administratively expensive workflows in American healthcare. Providers wait 90 to 180 days for credentialing completion while losing an estimated $6,000 to $8,000 per month in non-billable revenue per physician. Each physician application requires verification of up to 70 separate data elements, and because […]
Credentialing, Credentialing Technology, Delegated Credentialing
Delegated credentialing is an arrangement in which a health plan formally authorizes a healthcare organization (such as a hospital, physician group, or integrated delivery network) to perform the credentialing process on the health plan’s behalf. Instead of each insurance company independently verifying a provider’s credentials, the health plan accepts the organization’s credentialing decisions, provided the […]
Credentialing, Delegated Credentialing, Delegation Agreement