The Hidden Revenue Risk in Your Practice: Credentialing Delays and the $122,000 Problem

When Delays Don't Look Like Losses—But Are

You don’t need a report to tell you that healthcare is complicated. But what’s less visible—especially at the leadership level—is how much revenue leakage happens in the background while waiting for providers to be fully credentialed.

There’s no “credentialing delay” line item on your income statement.
But there is:

• A missing billing line for that new hire
• A growing stack of denied claims
• A surprise credentialing revalidation you didn’t see coming
• A provider seeing patients… but not generating revenue

And too often, the conversation goes like this:

“Why can’t we bill yet?”
“We’re still waiting on credentialing.”
“How long has it been?”
“It’s hard to say—let me check the tracker.”

If your organization is managing dozens—or even hundreds—of providers across multiple tax IDs and payors, you’re likely losing more revenue than you think.

The Numbers: Credentialing Delays by the Dollar

A recent analysis by TechTarget used U.S. Bureau of Labor Statistics (BLS) data to estimate just how much credentialing delays cost across different provider types over a typical 120-day enrollment period. Here’s what they found:

Source: TechTarget, March 2024

These are not theoretical losses. These are real opportunity costs tied directly to preventable delays in credentialing.

Even for small and mid-sized groups, the math is simple and sobering. Three new physicians delayed for four months? That’s a $366,000 revenue gap—and that doesn’t account for administrative overhead, patient impact, or lost provider satisfaction.

Where the Bottlenecks Hide

In most organizations, credentialing doesn’t fail because someone isn’t doing their job. It fails because the systems were never designed to manage this scale of complexity.

The most common culprits:

• Spreadsheets
  Credentialing teams are often managing dozens of providers across hundreds of enrollments with trackers that aren’t integrated with anything else. There’s no automation, no alerts, and no consistent reporting.
• Siloed teams
  Credentialing and billing aren’t talking. Implementation and compliance are guessing. Leadership gets updates when something breaks—not before.
• No visibility
  Who's enrolled with which payors? What effective dates are missing? What needs reattestation? Without a centralized system, those answers take hours to gather—and sometimes come too late.
• Not enough hands
  Your credentialing lead may be excellent. But no one can manage 50+ providers across 15+ payors alone without mistakes, missed deadlines, or burnout.

The Hidden Costs You’re Actually Paying For

Credentialing delays don’t show up in isolation. They affect:

• Billing timelines
  You can’t bill until a provider is enrolled—and you can’t back-bill in many cases (especially Medicare and Medicaid).
• Provider onboarding
  New hires expect to work. When they can’t, they get frustrated—and your staffing ROI drops fast.
• Compliance exposure
  Missed reattestations and outdated enrollment data can lead to clawbacks, fines, or network issues.
• Operations & morale
  When credentialing becomes reactive, it creates bottlenecks across departments—hurting performance and retention.

What a Better System Looks Like

This isn’t about buying software. It’s about creating structure and visibility in an area that’s historically been overlooked and under-supported.

At pie, we work with practices, health systems, and credentialing teams to build that structure through a combination of:

✅ Credentialing service expertise
Credentialers who understand payor behavior, timelines, and network dynamics

✅ Workflow automation and real-time visibility
Not just “tracking”—actual shared visibility into provider status, expirables, revalidations, and enrollment progress

✅ Support for growing, multi-site organizations
We work with multi-TIN, multi-state practices—tracking every provider across every payor, no matter how complex the setup

Right now, our platform is only available as part of our service model. That means you don’t just get software—you get people who use it to make your process work better.

What You Can Do Today

If you're a CFO, COO, or practice leader, here’s how to get a clearer picture of your exposure:

• Ask your credentialing team how many providers are currently out of network
• Find out how long it takes to complete an average enrollment across your top 5 payors
• Review how credentialing is tracked (Is it in a spreadsheet? Multiple? Shared drives?)
• Assess billing delays that might be tied to credentialing and onboarding issues

You might be shocked at how much money is being lost—quietly, consistently, and preventably.

Start Recovering Revenue Before It’s Lost

You don’t have to overhaul your whole system. But if your credentialing team is running everything in spreadsheets and flagged emails, that’s a sign it’s time to rethink your infrastructure.

We help teams build better credentialing operations—faster, clearer, and more accountable.

👉 Let’s talk.

Or if you’re just getting started, here’s a related read:
📘 Credentialing Still Runs on Spreadsheets. But At What Cost?