The Cost of a Credentialing Mistake

PAtient Safety, Healthcare, Credentialing, Provider CredentialingYou know the old saying “anything that can go wrong, will?” No one likes to admit this saying comes true more often than we’d like to admit, much less does anyone want it to happen to them at their work-place. But when mistakes happen during the credentialing or re-credentialing of a provider at your facility, it impacts more than just the bottom line.

Monetary Cost

Let’s get right to the dollars and cents, fixing a credentialing error means the time to investigate the error, paying fees for rework, and labor cost to fix the error.  This leads to delays which could result in forfeited reimbursements costing hundreds if not thousands of dollars.  And, if the error was to lead to litigation, the legal fees and settlement costs would be just the beginning of your troubles.

Patient Impact

Ensuring providers have the necessary credentials and clinical experience to be granted privileges at your facility is a difficult and important task. Imagine a provider performing surgery on you that he or she has only performed once.  Knowing which providers have the qualification to perform what procedures in your facility is a must – as a mistake in granting privileges could lead to patient injury or worse.

Provider Satisfaction

The credentialing and re-credentialing process is a tedious and laborious administrative task for providers.  They can spend hours if not days completing forms, scanning source documents, and attesting to questions. For them, this is time away from seeing patients which equates to loss of income for the provider and the healthcare organization.

Employee Expectations

A less obvious and likely over looked cost of a credentialing mistake is the impact on morale. Medical Staff Professionals strive for excellence and expect the organization in which they work to possess high quality standards. Having documented policies and procedures and a quality assurance program whose goal is to identify mistakes before they become costly is a win for everyone – staff, providers, and the organization.

Credentialing mistakes will happen, but there are ways to proactively minimize them – like investing in good credentialing and privileging software.  The right software can assist in ensuring all facets of a provider’s credentials are verified and provide notifications when a provider’s licenses or certificate are due to expire.  Additionally, having a privileging system tied to your credentialing will ensure providers are vetted with the appropriate training, experience, and clinical competencies needed!

Provider Credentialing


Kalli Sutton

About the Author
Kalli Sutton

Kalli Sutton is the Marketing Events Manager at symplr. She brings to the table a focus on marketing across all media outlets, digital marketing, content creation and marketing implementation practices. She received her bachelor’s degree in Marketing and Communications.

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