Credentialing Services

The 7 Most Common Challenges in Physician Credentialing

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The physician credentialing process is complex, tedious, and time-consuming. However, it’s an essential step in ensuring that patients receive care from qualified medical providers and that healthcare organizations can effectively screen their providers before they practice medicine. Still, physician credentialing is a challenge for all but the most organized and efficient healthcare institutions. There are a few key obstacles that impair the healthcare credentialing process, thus impacting the quality of patient care services. Here are some of the top reasons healthcare organizations struggle with physician credentialing and how a healthcare industry expert like PayrHealth can help.


The provider credentialing process requires massive amounts of documentation regarding education and training, including medical licenses, certificates, medical specialties, work history, board certifications, admitting privileges, and any malpractice claim. Assembling and checking these compilations can be extensive. And, any incomplete information or errors can also delay the medical credentialing process.

  • Solution: Make sure your providers have a record management framework that allows them to stay organized and keep track of all supporting documents. Make sure these documents are kept in a safe location and are easily accessible for re-credentialing.


Confirming a physician’s capabilities and history can be laborious, particularly while managing global medical alums or physicians with complex work histories. In many cases, these confirmations are done by hand, leading to delays. This is one area where artificial intelligence could be extremely beneficial.

  • Solution: Make sure to include clear and accessible contact information for each item (especially for peer references, hospital privileges, and professional licenses), allowing the approval process to move more quickly.


One of the biggest causes of processing delays is errors and incomplete information. Always check that you’ve provided proper education, work history, and licensing details to the fullest extent required for provider credentialing.

  • Solution: Gather proper credentials ahead of time and follow all instructions as presented. For challenging areas, consider creating a personal guide to ensure accuracy each time you go through the credentialing process.


Effective correspondence between medical staff administrations, credentialing boards, and physicians is essential. However, because of the busy nature of the healthcare industry, communication in a timely manner is often difficult, extending the credentialing process.

  • Solution: Be proactive about communicating with other healthcare providers, medical boards, and insurance companies so that you have the information you need well in advance of your credentialing process.

Administrative Changes

The healthcare industry relies on administration, which can change rapidly and often. Administrative changes and changes to federal laws can influence provider credentialing necessities and processes, making it difficult for healthcare providers to keep up. This can, in turn, cause errors and processing delays.

  • Solution: Ensure your healthcare providers remain up-to-date on any changes to the physician credentialing process, giving them appropriate reference materials to keep with their documentation.

Provider Burnout

Physician burnout is a problem throughout all of healthcare, but it can significantly impede the physician credentialing process. For physicians who are experiencing difficulties finding fulfillment in their work, the credentialing process can seem especially tedious.

  • Solution: Implement strategies to reduce burnout with resources and ways for providers to voice their concerns.


Many healthcare facilities still rely on out-of-date technologies for the physician credentialing process, making it even more challenging. When each healthcare provider must rely on outdated or broken technology, it can drastically extend the time required to fulfill physician credentialing.

  • Solution: Make it as easy as possible for providers to complete the process by implementing credentialing software and automated processes.

Healthcare Provider Credentialing with PayrHealth

Physician credentialing is an essential process for each healthcare professional that guarantees patient security and quality assurance. However, the process itself can be defeating for healthcare institutions, even impacting their ability to provide high-quality care. Partnering with a healthcare industry expert is one of the best ways to ensure timely and accurate provider credentialing, allowing your providers to focus on patient care without disruptions. To learn more about how PayrHealth can help your healthcare organization thrive, contact us today for a free consultation.

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