Credentialing sucks.
If you know, you know.
Credentialing sucks. If you know, you know. The endless data collection and organization for providers is just the beginning. With countless payers and hospitals involved, it’s inevitable that the process grinds to a halt somewhere, causing frustrating delays.
It’s an absurd yet necessary ordeal. There are 52 conventional credentialing steps to review before a healthcare provider can see patients and bill for their services. And just when you think you’re done, it’s almost time to start all over again in a couple of years.
Since this maddening process is essential for safe, quality outcomes, what we need is a major overhaul: more efficiency, more consolidation, and way more timeliness.
Resource: Using the credentialing calculator
To grasp the financial hit from inefficient credentialing, healthcare providers and groups can turn to our credentialing calculator. This nifty tool quantifies just how much potential net income gets lost in the black hole of credentialing delays and inefficiencies.
By plugging in data from current operations, providers can get a personalized estimate of the income they could reclaim by outsourcing to Fifth Avenue Healthcare Service’s credentialing verification organization (5ACVO). The calculator factors in the number of providers, average credentialing delays, and potential patient volume, offering a clear financial snapshot of the gains from a streamlined credentialing process.
This insight is crucial for decision-makers weighing the ROI of outsourcing their credentialing operations.
Credentialing Calculator
| Specialty (Pick in drop down) >> | Double Click here to choose specialty | ||
| Enter Number of Providers >> | 0 | ||
| Annual Net Income Generated by Specialty | 0 | ||
| National Average Number Of Days For Enrollment | 92 | ||
| Our Average Number Of Days For Enrollment | 37 | ||
| Potential Additional Net Income Per Provider | 0 | ||
| Potential Additional Net Income Per Group | 0 | ||
| Specialties | Average Annual Net Income | Average Salary | |
| Cardiology (Invasive) | 3484375 | 590000 | |
| Cardiology (Non-Invasive) | 2310000 | 427000 | |
| Cardiovascular Surgery | 3697916 | 425000 | |
| Family Practice | 2111931 | 241000 | |
| Gastroenterology | 2965277 | 487000 | |
| General Surgery | 2707317 | 350000 | |
| Hematology/Concology | 2855000 | 425000 | |
| Internal Medicine | 2675387 | 261000 | |
| Nephrology | 1789062 | 272000 | |
| Neurology | 2052884 | 301000 | |
| Neurosurgery | 3437500 | 687000 | |
| OB/GYN | 2024193 | 324000 | |
| Ophthalmology | 1440217 | 300000 | |
| Orthopedic Surgery | 3286764 | 533000 | |
| Otolaryngology | 1937500 | 405000 | |
| Pediatrics | 1612500 | 230000 | |
| Psychiatry | 1820512 | 261000 | |
| Pulmonology | 2361111 | 418000 | |
| Urology | 2161458 | 386000 | |
| Mixed Specialties: Use Average | 2378727 | - | |
| Source: Merritt Hawkins 2018 Review of Physician Recruiting Incentives |
| Research or Metric Used For Revenue Multiple | Days | |
| NAMSS research shows a CVO is 5-7 days faster | 5 | |
| National Average Days For Provider Enrollment | 92 | |
| Primoris Average Days For Provider Enrollment | 37 | |
| BCBS Primoris Avg Enrollment Time | 27 | |
| Aetna Primoris Avg Enrollment Time | 33 | |
| United Primoris Avg Enrollment Time | 9 | |
| Source: BCBS, Aetna and UHC from research 10/1/21 study. Primoris Average 37 days based on case study and results on 4/5/23 based on 38 different payers including delegated and nondelegated payers such as Aenta, Medica, OK SoonerCare, and Blue Advantage PPO (BVP). |
Credentialing really just sucks but it doesn’t have to. We can help.
