Need Urgent Credentialing? 11 Smart Ways to Get Credentialed Fast Without Delays

If you’ve ever rapidly typed a question in Google like “I need credentialing asap,” you’re not alone. Most independent providers and small-practice owners also encounter this situation.  

Delays in credentialing may result in lost weeks or even months of revenue, frustrated patient populations, and delayed onboarding for newly hired clinicians. 

It does not have to be so lengthy when it comes to provider enrollment if you are aware of where the bottlenecks exist and how to work around them. The right strategy will help you obtain credentials quickly, remain compliant with insurance payers, and reduce the stress of insurance credentialing delays. This blog will provide you with 11 proven, practical ways to expedite your credentialing process for doctors, streamline quick physician credentialing, and say goodbye to months of waiting.  

Why You Might Need Urgent Credentialing 

When both time and money are at stake, the need for urgent physician credentialing becomes apparent. To many physicians, credentialing is an unseen gatekeeper from being able to start seeing and treating patients (and therefore charging them) to being allowed to bill those same patients for treatment.  

Below are the most common scenarios in which urgent physician credentialing is no longer negotiable. 

• Opening a new practice (solo or group): You may be unable to submit claims to any insurance carriers until you are fully credentialed by them. This means you would either have to see only cash-paying patients or close your doors, as this business model cannot sustain itself in the long term. 

• New hire or employment in a hospital-based group: Most employers and hospital-based groups require completion of your physician credentialing and hospital privileging before they allow you to join their panels. 

• Changes to insurance panels or tax ID numbers: Whenever you make a change to your practice ownership, location, or NPI number, you will typically be required to recredential and re-enroll. This can delay reimbursement if not handled proactively. 

• Additional physicians or office expansion: Fast credentialing enables multi-provider and multi-site practices to grow while limiting delays in patient care caused by credentialing backlogs. 

How Long Does Credentialing Usually Take? 

The time required for the credentialing process for physicians can vary anywhere from 60 to 120 days. However, based on the volume of work, the number of other applicants seeking credentialing at the same time as you, and how quickly the various entities involved in verifying your credentials respond to payers’ requests for verification, the timeframe may be longer than 120 days. Understanding typical processing times will help you determine what is realistic and when to intervene to expedite the credentialing process. 

Here is a general outline of the credentialing process and the typical time required for each portion. 

• Initial review and submission (1 to 2 weeks): The payer verifies that your application has been completed and that all necessary documentation has been included with your submission.  

• Verification of primary sources (4 to 6 weeks): One of the most time-consuming aspects of the credentialing process is obtaining verification of specific information by contacting medical licensing boards, board-certifying organizations, malpractice carriers, and other relevant entities.  

• Credentialing committee review (2 to 4 weeks): Following receipt of verification of primary sources, a credentialing committee reviews your file to determine if there are any ‘red flag’ items that need further investigation. If everything appears acceptable to the committee, they vote to approve your credentials.  

• Loading credentials and activation in the payer system (1 to 2 weeks): After your credentials are approved by the credentialing committee, the payer must upload them into their internal system. At which point, you will be able to begin submitting claims for reimbursement. 

Why credentialing takes so long: Payers do not simply rubber-stamp applications. In fact, payers are statutorily mandated to verify every item of information in an applicant’s credentialing package. Therefore, when medical licensing boards or malpractice providers are slow to provide attestation for specific information, the overall credentialing turnaround time is significantly extended.  

Therefore, employing strategies to enhance the efficiency of the credentialing process and to shorten insurance credentialing delays has significant implications for day-to-day operational efficiencies in physician practices. 

11 Smart Ways to Get Credentialed Fast 

When you are thinking “I need to be credentialled asap”, there are ways that can help fast-track the credentialing process for providers. These methods will help you navigate the credentialing process by eliminating many unnecessary delays.   

Prepare All Documents in Advance 

Your speed begins with your planning. The physician credentialing process is well known for repeatedly requesting the same set of documents. Therefore, if you do not have all your documentation prepared prior to submission, you will be delayed from the start. 

Examples of common documents requested during the credentialing process include: 

• State medical licenses, one for each practice state 

• DEA certificate 

• Malpractice insurance profile, including dates, limits, and tail coverage 

• Board certifications, if necessary 

• Current resume listing monthly employment history 

• Affiliation letters and hospital privileging summaries from hospitals/facilities 

• W-9, confirmation of NPI, and proof of practice address 

Create a ‘credentialing folder’, whether physical or digital, and keep copies of all documentation in a clean PDF format. In addition, place an expiration date on each document so you can renew it promptly and avoid insurance credentialing delays. Once you are ready to submit the information, you can upload everything into the forms very rapidly, greatly improving your credentialing turnaround time.  

Keep Your CAQH Profile Updated 

Your CAQH ProView profile is the primary system used in nearly all provider enrollment processes. Almost all payers pull their information from this site. Therefore, when your CAQH profile is out of date, incomplete, or does not consistently reflect your current information, it will be the primary reason for delays in your credentialing process. 

To ensure that there are no delays with the insurance credentialing process: 

• Re-apply to update your CAQH Profile (even if there have been no changes) approximately every 120 days. 

• Ensure your uploaded PDFs are clear and readable, and include full-page images of your licenses, DEA, malpractice, and board certifications. 

• Verify that the information included in your CAQH Profile accurately reflects your practice location, telephone number, and NPI as entered on each application submitted to a payer. 

• Submit new affiliations, such as a new hospital, medical group, or telemedicine platform, as soon as they become active. 

Your CAQH profile can be accessed and managed through the CAQH ProView portal. By regularly managing your CAQH profile, you can expedite your credentialing and minimize disruptions caused by provider enrollment delays.  

Apply to Multiple Insurance Payers Early 

One of the most common credentialing mistakes is credentialing with a single payer at a time. If you are in a rush to get credentialed, you should work all key payers in parallel, not sequentially.  

​For example, when opening a new practice and wanting to launch your services immediately, it doesn’t make sense to wait for Aetna approval before starting the application process with Cigna or UnitedHealthcare. The longer you wait to apply to each payer, the longer your actual effective credentialing cycle will be, and that can easily become 3 to 4 months.  

• Start with the major local players and/or those who serve in the general demographics.  

• Next, follow up promptly with Medicare and Medicaid, as they usually take longer, but both have an impact on how other payers view providers.  

• Once you have a basic network in place, add some regional or specialty-specific plans.  

By submitting multiple applications, you improve your chances of having at least one or two payers activated while you wait for the one perfect but slow-moving plan.  

Ensure Accurate Application Submission 

Accuracy is the quiet catalyst of the doctor’s credentialing process and the quiet assassin of delayed approvals. One error, as small as an address discrepancy, will flag your file and return it to you, or it will sit in the review queue much longer than it should. Some common errors that delay the insurance credentialing process include: 

• Any work history gap that occurs within a calendar month creates red-flag conditions and usually requires an explanation from the provider. 

• Date discrepancies and address discrepancies on different applications, CAQH, and licensure information 

• NPI, tax ID number discrepancies 

• Unsigned portions of applications or witness signatures. 

• Malpractice policy and expired licenses that are not updated prior to submission 

Take a moment to compare each item below line by line before submitting it to payers. 

• CAQH profile 

• Payer application 

• Actual license and malpractice policy document 

If possible, have someone else review this material (e.g., an administrative assistant or credentialing specialist). This can save you significant time waiting for follow-up questions and additional documentation.  

Follow Up Regularly with Payers 

Many providers believe that submitting their data constitutes the final act in the enrollment process with a payer. However, as noted previously, the credentialing and contracting process is generally considered a relationship and therefore requires ongoing maintenance. Therefore, if a provider does not follow up with the payer regarding the status of their submitted file, there will be little to no incentive for the payer to expedite its review compared with other submissions they may receive. 

Therefore, effective follow-up should include: 

• A call to the payer or an email, approximately every 7 to 10 working days after submission, to inquire about the status of the provider’s file 

• Request the payer for a tracking number or case reference to track the status of the provider’s file. 

• An inquiry regarding whether there are any outstanding issues pending related to the provider’s file, or if additional documentation is required to complete the credentialing and contracting process. 

To manage multiple payers at the same time, you can utilize a basic spreadsheet or a provider application management tool to keep track of the following information for each provider and payer: 

• Payer name 

• Date submitted 

• Date last contacted 

• Date of the next follow-up 

• Current status

Work with Fast Credentialing Services 

With a rapid credentialing service as your partner, when you need an immediate solution to get credentialed quickly, they will assist with physician credentialing, provider enrollment, and urgent provider enrollment for numerous clinicians each year, sometimes even with faster turnaround times than what your practice could accomplish independently. 

The typical advantages that you will experience are: 

• Faster approvals: Expert credentialing groups understand which payers offer expedited approval, delegated credentialing, or other payer-specific onboarding processes. 

• Reduced administrative burden: Staff can continue to provide high-quality patient care while the credentialing firm manages paperwork, follow-up communications, and monitoring. 

• Lower risk of denial: Credentialing teams recognize the most common mistakes made during this process and can educate your organization on how to avoid preventable insurance credentialing delays. 

• Improved payer relationships: Credentialing firms typically maintain direct relationships with individuals in payer credentialing departments, thereby reducing the time to resolve escalated issues. 

For physicians and clinicians currently balancing clinical responsibilities, marketing initiatives, and operational management, outsourcing the credentialing function is no longer an add-on; it is a necessary component of your overall strategy to get credentialed quickly.  

Use Delegated Credentialing (if available) 

If you are affiliated with a hospital, multi-provider group, or larger health system, you may be eligible to use delegated credentialing. This method allows your organization to obtain formal payer authorization to perform internal credentialing for all physicians practicing within your organization. Hence, it shortens the time it takes them to begin seeing patients covered by that particular payer network. 

The typical workflow for delegated credentialing is as follows: 

• Your organization will submit its credentials to the designated payers, and the payers will also complete primary source verifications.  

• Following completion of these actions, the payers will accept your organization’s vetting process, in lieu of conducting their own full verification.  

• This should typically allow you to see patients in the specific payer network much more quickly than you otherwise would. 

Delegated credentialing has been found particularly helpful for specialists, hospitalists, and emergency medicine physicians working in hospitals.  

Avoid Common Documentation Errors 

The smallest documentation details can cause serious delays in provider credentialing. While some of these details may seem minor to correct, doing so is time-consuming.  

Some examples of common documentation mistakes include: 

• Missing or improperly formatted malpractice insurance information (e.g., incorrect dates of coverage, incorrect policy limits, etc.), as well as tail coverage.  

• Inconsistencies with your practice address listed on CAQH, applications, and legal documents.  

• Expired or unlicensed state license or DEA certificate. As soon as you have a lapse during a credentialing process, it will require a complete review.  

• Unverifiable affiliations, that is, if a hospital or former employer cannot verify their relationship with you, you will likely need to present other verification forms. 

Using a simple provider application management checklist can help prevent many of these types of problems. Using this checklist when managing quick physician credentialing for multiple providers multiplies its effectiveness.  

Track Your Application Status 

Credentialing can be a long-term process, and it may be difficult to understand the status of all files. If there are no systems to monitor the status of applications, then you may not be aware that one payer has been “pending” for weeks while you wait for approval from another. 

• Develop an Excel sheet to track submitted applications. Alternatively, use application management software that allows you to track the status of each applicant (submitted, pending verification, committee review, approved, activated) 

• Establish calendar reminders for follow-up on a timely basis 

• Create a routine to review at least one payer’s status each week 

While tracking is not easy, it will help you expedite the credentialing process and ensure no application is lost in the queue. Additionally, monitoring your credentialing status allows you to better inform your staff, patients, and referral partners about when you expect to be able to submit claims to their plans.  

Prioritize Medicare and Medicaid Enrollment 

If you’re going to provide medical services to a large number of patients, Medicare and Medicaid are almost always mandatory to enroll in. 

Therefore, when enrolling providers with Medicare and Medicaid, do so first, even if all commercial payer credentialing processes have not yet been completed. CMS has an online system called the Provider Enrollment, Chain, and Ownership System (PECOS), where you can submit and track your application for Medicare and Medicaid provider enrollment. 

The benefits of doing this earlier include: 

• Aligns your practice with the largest payers in your market 

• Commercial payers will often reference your Medicare-approved status as part of their decision on whether they want to take on the risk of credentialing you, thereby helping to expedite the credentialing process for your private insurance credentials. 

• Gives more clarity on how quickly you’ll be able to bill  

• You can learn more and apply through the CMS PECOS portal.

Hire an Experienced Credentialing Team 

As your practice grows or enters more complex credentialing areas (e.g., multi-state credentialing, group revalidation, or specialty-specific payers), DIY credentialing will become impractical. A professional, experienced physician credentialing team may be one of the best investments you can make at this time. 

A good credentialing team will typically provide the following services: 

• End-to-end management of your credentials from application preparation through the final activation and re- validation of the practitioner’s credentials 

• CAQH oversight of the practitioner’s re-attestation, documentation upload requests, and updates to the practitioner’s profile 

• Communication with each insurance payer regarding the status of the practitioner’s application 

• Credex Healthcare team provides you with dashboards or regular reports on which practitioners are approved, pending approval, or require follow-up by your staff 

A dedicated credentialing team can aid busy physicians who are continually adding new clinicians to their staff or opening new offices. What may appear to be a confusing and laborious process to manage can become a consistent, manageable, and scalable process that aligns with your growth objectives. An expert credentialing team like Credex Healthcare is a cost-effective means to expedite the credentialing process and maintain timely enrollment of healthcare providers. 

Common Mistakes That Delay Credentialing 

Well-intentioned healthcare providers make many of the same errors that delay physicians’ credentialing and cause unnecessary delays in their insurance credentialing. Here are typical problems and how to avoid them when it comes to delays in obtaining credentialing: 

• Incomplete or outdated documents: If you do not provide all necessary documents, or if your licenses have expired during the credentialing process, payers will either stop processing your application or reject your file. 

• Inconsistent information across sources: If your CAQH lists an address, but your medical license lists a different address than your W-9, payers will question everything about your credentials. 

• Overlooking re-attestation deadlines: Your CAQH will become inactive after 120 days. Then, your credentialing committee will ask you to update your profile, which will likely stall your progress. 

• Not following up on files: Your files could sit stagnant for several weeks before you find out what happened, due to a lack of regular follow-up.  

• Incomplete work history: Credentialing committees are trained to identify gaps in employment. Therefore, you should account for each of these every month. If there are any gaps, you may need to explain why those gaps exist. 

The sooner you recognize that these types of errors occur and begin implementing processes to eliminate them, such as checklists and tracking systems, the faster you can complete the credentialing process. 

Benefits of Fast Credentialing Services 

The faster approval times and shorter timelines achieved through the expertise of a professional team will also save your practice administrative costs and lost revenue from delayed credentialing. 

• Administrative burden: Your staff will be available to provide patient care and manage appointments and office operations, rather than having to deal with different departmental payers. 

• Compliance and denial reductions: The likelihood of receiving RAIs or denials that cause additional delays in your credentialing processes will decrease. 

• Scalability: If you’re expanding at an accelerated rate or establishing multiple new offices and clinics, having an outside vendor handle credentialing will allow you to onboard new physicians with less overhead and stress. 

In many cases, the initial investment in obtaining rapid credentialing assistance will be quickly recouped when your practice can start billing earlier and begin contracting with insurance companies to attract additional patients. 

When Should You Seek Professional Help? 

While healthcare providers can handle most of the work themselves, when you are dealing with the following situations, you need some professional help: 

• Urgently needing a provider enrolled for a new practice opening 

• Credentialing across multiple states, and have payers that follow different credentialing guidelines and have overlapping processes 

• Complex specialty or group revalidations 

• Staff shortage in your administrative staff 

The credentialing experts already understand how to expedite the credentialing process, manage CAQH updates, and resolve issues with stalled credentialing applications. 

FAQs 

Q: How can I get credentialed fast? 

Organize all necessary paperwork before beginning the application process for each payer. Additionally, ensure that all of your information in CAQH is up to date. Submit all of the paperwork for the different payers at the same time. Follow up regularly with the payers regarding the status of your application. 

Q: What is the fastest way to complete credentialing? 

Choose an outsourced credentialing company that has relationships with all payers. The outsourced company will manage tracking of applications submitted to individual payers and assist with following up on their status. 

Q: Can credentialing be expedited? 

Yes. However, this depends on each payer’s internal timelines. If you are being delegated through a hospital or group, they may have an advantage over you when it comes to receiving expedited processing of your credentialing application. 

Q: Why does credentialing take so long? 

Each payer independently verifies your qualifications and licenses prior to granting you credentialing. This includes verifying that you are licensed to practice medicine in each state where you wish to see patients. The verification also involves coordination with other third-party organizations, including state medical boards and insurance companies. 

Conclusion  

If you are thinking, “I need credentialing now”, remember that speed comes from preparation, accuracy, and persistence. Organize your documentation well, maintain a clean CAQH, and work closely with qualified credentialing professionals to achieve fast-tracked credentialing. 

Don’t let delays hinder your startup or provider journey. Apply these ideas immediately to help you get ahead of insurance timelines.