Factors to consider before outsourcing professional credentialing service.


Provider credentialing is a prolonged and complex practice. Over the years, credentialing has been of utmost importance in the healthcare industry. It is important to cut short the time of credentialing. Outsourcing medical credentialing services is a perfect option to minimize the time, cost, and incompetence.

Provider credentialing

Provider credentialing is a process in which the insurance companies and healthcare institutes verify the educational experience. Provider credentialing is a process that all healthcare professionals undergo after regular intervals. Eventually, provider credentialing is a verifying professional and personal documentation for workforces. Provider credentialing is vital in healthcare because it makes sure that the provider has the necessary educational qualification to provide the specific services. Payor credentialing is of two types.

Onboarding and Payor credentialing.

Onboarding credentialing is used as an alternative term used for physician credentialing. Physician credentialing is a comprehensive verification of the provider’s educational degrees, certifications, and training certificates.

Payor credentialing is the process of verification of educational and experience certifications. A healthcare provider must meet the professional requirements and maintain compliance with the insurance provider.

The mention below is the reason why you should outsource provider credentialing services. You can outsource the provider credentialing service to automate and speed up the process.

Enhanced ROI

If you hire a healthcare provider and the credentialing process for the candidate takes more than three months, you are losing a sum of money. Because without credentialing process, it is illegal for the healthcare provider to see the patients. You can reduce the cost, paperwork, and staff by outsourcing the complete process to the professional credentialing service provider. You can save around 20% to 80% cost by outsourcing. You can also reduce the time of credentialing and onboarding process. The total credentialing overheads can also lessen to attain countless earnings on investment ROI.

Minimizing Human Error

Provider credentialing is a complicated process. It can be more difficult when the in-house credentialing team tries to complete the process manually. In fact provider, the credentialing process needs fact-checking of multiple educational and experience degrees. A minor error, spelling of a place or name, can lead to an objection or discrepancy in the application, even rejection. The probabilities of human error are considerably extra in a manual course than in an computerized one. After the first rejection, your time will require a lot of time to identify the error, rectify it and resubmit the application.

Outsourcing a professional credentialing service provider can minimize the mistakes that your in-house team cannot make. A professional credentialing service provider owns experienced and qualified staff and automated software. A credentialing service provider with automated systems can conduct real-time checks for the background of the documents and automatically send reminders to the concerns. Automated is a proven way to reduce the overall mistake rate and time to complete the credentialing process. The professional credentialing service provider can help reduce any complications in the process.


A successful healthcare facility must work with multiple insurance providers. Every single insurance company has separate requirements for documentation, and credentials. Maintaining the in-house team of credentialing personnel is not only expensive, but it is also difficult to keep track of every insurance company. Secondly, a single error or omission of the date can result in serious consequences for the healthcare provider and the facility. In extreme cases, the provider may lose their license, and the business can face penalties and malpractice claims.

Outsourcing a provider credentialing service will help maintain compliance with every insurance company. They can provide re-credentialing services as well. They can initiate the process on time, and before the expiry of the previous credentialing process, re-credentialing completes

Turnover time

Commonly, the credentialing process takes thirty to one twenty days for verification of the credentials of the healthcare provider. The process can be lengthy if you try to enlist your candidate from multiple insurance providers. Credentialing with multiple insurance companies comes with the benefits of vide range of claims clearance, yet the multiple do

Outsourcing an automated medical credentialing service can improve the turnover time for projects and onboarding. The automated credentialing solutions help the outsourced professional credentialing service provider complete the payor credentialing process within 10 to 15 days.

Improves efficiency

Many healthcare facilities have in-house teams for every process, yet they face delays due to paperwork and lack of organization. Secondly, the credentialing process requires consistent updates.

Outsourcing a professional credentialing service provider to deal with documents, check, verify, update and revise, and complete the process saves your team’s time and labor.


Maintaining in-house credentialing is tiresome, time-taking, and requires money. To avoid a negative impact on the business, outsourcing professional credentialing services is a good choice.