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Credentialing a growing priority for revenue cycle leaders

Questioner

So Sangeeta, Why is credentialing becoming such a big focus for revenue cycle leaders?

Sangeeta

Credentialing directly impacts reimbursement. If a provider isn’t properly credentialed and enrolled with payers, their claims get denied, which can stall millions in revenue.

A delay of even 30–60 days in enrollment can mean tens of thousands of dollars lost per provider. In 2024–25, organizations are realizing that credentialing isn’t just compliance—it’s revenue protection.

Revenue Cycle leaders are now integrating credentialing into RCM workflows, using real-time dashboards, and measuring metrics like “days to enrollment” and “first-pass acceptance rate” for claims. Instead of seeing it as paperwork, the industry is reframing credentialing as a revenue driver.

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