πŸ‡ΊπŸ‡ΈUnited States

Idle Physicians Due to Credentialing Bottlenecks

3 verified sources

Definition

Providers wait 90-150 days to be fully credentialed, preventing them from seeing patients or utilizing facilities. This leads to underused exam rooms, staff idle time, and lost appointment slots across practices. Recredentialing failures exacerbate periodic capacity gaps every few years.

Key Findings

  • Financial Impact: $50,000-$200,000 per provider annually from downtime
  • Frequency: Weekly during peak application backlogs
  • Root Cause: Lengthy verifications, peer reference delays, and redundant applications per payer

Why This Matters

This pain point represents a significant opportunity for B2B solutions targeting Physicians.

Affected Stakeholders

Clinical Directors, Practice Owners, Credentialing Specialists

Deep Analysis (Premium)

Financial Impact

$10,000-$30,000 per provider annually from delayed employer patient assignment and scheduling inefficiency β€’ $10,000-$35,000 per provider annually from delayed military patient scheduling and administrative overhead β€’ $100,000-$150,000 per provider annually; Medicare patients represent 30-40% of practice revenue; enrollment delays prevent billing to largest payer

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Current Workarounds

Administrator maintains master spreadsheet with credentialing status for each payer; sends weekly status update emails to physicians; manually calls payers for status β€’ Administrator maintains multi-payer WC tracking spreadsheet; manually submits to each payer; makes 2-3 follow-up calls per week to different WC carriers β€’ Administrator maintains separate Medicare tracking sheet; calls Medicare contractor every 2 weeks; manually inputs status into practice management system

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Methodology & Sources

Data collected via OSINT from regulatory filings, industry audits, and verified case studies.

Evidence Sources:

Related Business Risks

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