Provider Credentialing Issues in healthcare

If you are a provider and you are going to start the credentialing process then you need to read this provider credentialing issue in healthcare. We observed that there are many potential issues and potential costs in the provider credentialing process. Actually, provider credentialing is the most important compliance issue in medical practice. Without credentialing process mistakes and data insight or errors, those which may occur in the provider credentialing process can be harmful to your medical practice.

As soon as you get rid of credentialing issues you can focus on your day-in-day-out activities. You cannot ignore the significance of provider credentialing as it is certainly one of the most critical compliance that a provider medical practice may encounter while practicing.

Most common Provider Credentialing issues:

We at MBC can easily eliminate the below issues for your practice, to make your provider credentialing process smoother.

Organization Issue

As a physician you need to focus on your patients and not on compliances execution, so you can always assign a coordinator to your provider credentialing process. You can outsource this to MBC credentialing team, we have a qualified credentialing team who is proficient in provider credentialing work. We will keep the office on schedule, remind the insurance company by sending out reminder texts and emails, and keep an eye that no credentialing expires. This can save your practice revenue in appeals and lost reimbursements.

Compliance with State Regulations

Each state in the US has set provider credentialing standards and medical services policy guidelines. Also, national organizations like CAQH have involvement in specific requirements. This can create issues in the provider credentialing process, as the requirements can vary state to state with different provider credentialing policies or legislature. Your credentialing person or team should be updated with these different regulations and incorporate revised requirements as they occur in real-time.

Privacy and Security

While applying for provider credentialing, you need to share your personal information. The background check is a vital aspect of credentialing. Apart from eligibility requirements, like degrees or previous credentialing checks, ensure that the applicant follows national licensing requirements. Privacy and security are important in this step of the process and forward.

We are a HIPAA compliance billing service provider company. We follow all HIPAA rules and regulations in our organization so you can trust us to outsource your provider credentialing.


Your practice will always have an issue if you suppose to make your schedule work around the less time to process a credential. Most carriers promise that they take around 90 days, the truth is often it takes around 150 to 180 days. Each payer has its own credentialing timeline, and most offices do not have the control or the time to challenge them on their timings. As a safe side, you can assume the maximum time no matter what. If it takes less time then you will be ahead of your pre-decided schedule.

We have a separate credentialing team that is equipped will all documentation requirements in place and have all the time to process your credentialing form to the insurance company. You can rely on MBC for getting Provider Credentialing issues resolved within time.

If you have any questions related to the provider credentialing process for your practice or if you are willing to know how to increase your reimbursement, contact us today for a free consultation at 888-357-3226 or email me at