NCQA’s 2025 updates require faster primary source verification (within 90–120 days), monthly license and sanction checks, stronger data documentation, and stricter delegation oversight. These standards enhance accuracy, compliance, and patient safety.

For credentialing with commercial insurance payers, the typical turnaround time ranges between 90 to 120 days, although anywhere from 45 to 180 days is not uncommon depending on the payer and completeness of documentation

Avoid revenue loss from credentialing delays by starting early, keeping documentation accurate, and using expert credentialing services to speed up payer approvals.

Poor credentialing practices can severely impact both patient volume and trust. When providers are not properly credentialed, delays or denials in insurance participation occur, limiting patients’ ability to access covered care. This leads to appointment cancellations, revenue loss, and damaged ...

Credentialing checks a provider’s qualifications, while enrollment connects them to insurance networks for payments. Knowing the difference helps avoid claim delays and ensures smooth reimbursement.

As healthcare group practices expand, managing delegated credentialing becomes increasingly complex—but when handled efficiently, it can significantly reduce payer delays and accelerate reimbursements. Delegated credentialing allows practices to manage provider credentialing on behalf of payers, offering faster onboarding and more ...