One of the most frequently asked questions in medical staff services is, “How long does credentialing take?” The answer, of course, depends on the type of healthcare setting, the complexity of the practitioner’s credentials, and the thoroughness of the process. For Provider Lifecycle Professionals (PLPs), understanding and effectively communicating these timelines is key to setting realistic expectations and maintaining operational efficiency.
Credentialing Turnaround Times by Setting
Turnaround times can vary significantly depending on where a practitioner will practice. Here’s a breakdown of typical credentialing timelines across different settings:
- Hospitals/Health Systems: 30 to 90 days
- Managed Care Organizations (MCOs): 60 to 120 days
- Ambulatory Surgery Centers (ASCs): 30 to 60 days
- Telemedicine Practitioners: 15 to 45 days
- Locum Tenens Practitioners: 1 to 4 weeks
Hospitals and MCOs tend to have the longest timelines due to the complexity and volume of their credentialing processes. In contrast, telemedicine and locum tenens credentialing are often expedited to address immediate patient care needs.
Breaking Down PLP Processing Times
PLPs play a pivotal role in moving credentialing forward. The process typically involves three stages:
Application Review (1-2 Days): The first step involves checking the application for completeness. Missing or incorrect information can cause delays, so thoroughness here is crucial.
Primary Source Verification (5-10 Days): PSV ensures that the practitioner’s credentials—such as licensure, education, and training—are verified directly from the source. While the timeline may vary depending on the responsiveness of institutions, most verifications are completed within 5 to 10 days.
Evaluation and Recommendation (1-4 Weeks): The final stage involves committee review, risk assessment, and recommendations. This step often takes the longest due to the coordination required for committee meetings and evaluations.
Why Turnaround Times Matter
Credentialing turnaround times affect more than just practitioner onboarding—they impact patient care, revenue cycles, and organizational compliance. For instance, delays in managed care credentialing can postpone reimbursements, while slow hospital credentialing can leave critical departments understaffed.
Moreover, setting accurate expectations about turnaround times can strengthen trust between PLPs, practitioners, and healthcare organizations. When everyone understands the timeline, frustrations are minimized, and the focus stays on delivering quality care.
Managing Expectations
Healthcare leaders and practitioners often push for faster credentialing, but certain factors are beyond an PLP’s control, including:
Incomplete Applications: Even one missing document can delay the process by days or weeks.
Unresponsive Institutions: Licensing boards and educational institutions may take longer than anticipated to verify credentials.
Committee Schedules: Credentialing committees typically meet at predetermined intervals, which can delay final approval.
By clearly communicating these potential delays upfront, PLPs can foster greater understanding and patience from stakeholders.
Tips for Reducing Turnaround Times
Although some delays are unavoidable, PLPs can take proactive steps to streamline the process:
Prepare Practitioners Early: Share a detailed checklist of required documents to prevent incomplete applications.
Utilize Credentialing Software: Automating PSV and tracking deadlines can shave days off the process.
Streamline Internal Processes: Create a clear workflow for application reviews and committee evaluations.
Credentialing turnaround times are a frequent concern in healthcare, but with proper planning and communication, they can be managed effectively. PLPs are instrumental in ensuring that credentialing stays on track, ultimately enabling organizations to deliver timely, high-quality care. By setting realistic expectations and leveraging efficient processes, PLPs can turn a potential bottleneck into a seamless part of healthcare operations.