The Credentialing Bottleneck: How Pre-Verified Physicians Cut Onboarding Time from 90 to 60 Days

You hired a virtualist. The physician is ready to start. The credentialing process tells you to wait 90 days.

This is the credentialing bottleneck, and it costs health systems hundreds of thousands of dollars annually.

What Dr. Berkowitz Learned Building KeyCare Across 50 States

When Dr. Lyle Berkowitz built KeyCare, he faced a critical challenge: scaling a national medical group meant credentialing physicians across multiple states with multiple payers.

He articulated the fundamental problem:

"The issue is all about execution. When can we do it? When does it make sense? The vision has always been clear. The execution has been the much harder part."

For credentialing, the vision is clear: verify physicians, credential them, and get them productive.

The execution? Brutal.

Dr.Berkowitz had to solve credentialing at scale. One physician might need credentialing with:

• Medicare
• Medicaid in 5 different states
• United Healthcare
• Aetna
• Cigna
• Empire Blue Cross

That's 10+ separate credentialing processes for one virtualist across multiple states.

Multiply by 50 virtualists and you're managing 500+ credentialing processes simultaneously.

What Is Credentialing?

Credentialing is the process of verifying a physician's qualifications, training, board certification, malpractice history, and background.

It's required by:

• Medicare and Medicaid
• Private insurance companies (United, Aetna, Cigna, Humana)
• The Joint Commission (hospital accreditation body)
• Many health systems internally

It's non-negotiable. You can't bill for a physician's services until they're credentialed with the relevant payers.

The Credentialing Process (Traditional)

Here's the typical workflow:

1. Collect documents from physician (10-15 required documents): diploma, board certification, DEA registration, malpractice history, state medical license, references
2. Verify education and training (call schools, residency programs)
3. Verify board certification (call board certification bodies)
4. Run criminal background check
5. Check malpractice history (NPDB, state databases)
6. Submit to each payer (Medicare, Medicaid, United, Aetna, Cigna, etc.)
7. Wait for each payer to review and approve (30-60 days per payer)
8. Final review and approval

Total timeline: 90-120 days

Why This Is Slow

Payers don't prioritize credentialing. They receive hundreds of applications weekly.

Verification steps are manual. Someone calls your residency program to verify you trained there. Someone else calls to verify board certification.

Some payers require in-person visits for certain specialties or initial credentialing.

Document collection is slow (you call the physician, physician gathers documents, mails them to you, you review them, you send them to payers, payers request clarifications, repeat).

The Cost of Delay

Each month a credentialing delay costs:

• Missed revenue: Virtualist ready to work but not credentialed. No revenue generation.
• 12 patients/day x $100/visit x 20 days = $24,000 per month
• Overflow costs: Health system uses transactional telehealth vendor to cover the gap.
• Transactional model reimburses 60% of normal rate (expensive vendor markup)
• $150 per visit instead of $100

Delayed program launch: Health system promised patients virtual care access by Q2. Credentialing delays push to Q3.

Real Numbers

A health system hiring three virtualists faces a total credentialing delay cost:

Three virtualists x $24,000/month x 3 months average delay = $216,000 lost revenue

Plus overflow costs (using external vendors at markup) = additional $50 k-$100k

Total cost of credentialing delay: $266k-$316k

How DirectShifts Solves This

DirectShifts maintains detailed credentialing records on 800k+ physicians.

When a DirectShifts physician is hired:

• Pre-verification already done: DirectShifts has already verified education, training, board certification, background.
• Faster document collection: DirectShifts has documents on file. Physicians don't need to re-collect.
• Pre-credentialing data: When you submit to payers, you're submitting verified data that's already been vetted.
• Payer relationships: DirectShifts has established relationships with payers, expediting review.

Result: Credentialing timeline drops from 90 days to 60 days.

The 4-Week Gain

4 weeks faster credentialing = $24,000 x 4 weeks = $96,000 in recovered revenue per virtualist.

For a health system hiring three virtualists: $288,000 in recovered revenue.

This easily offsets any fees for using DirectShifts' platform and pre-verification data.

Dr.Berkowitz's Core Insight on Execution

Berkowitz built KeyCare on a principle that applies directly to credentialing:

"Chance favors a prepared mind."

DirectShifts is the prepared mind. We've done the credentialing homework. We maintain relationships with payers. We have verified data. When you need a physician, we're ready.

This prep work saves you months and hundreds of thousands of dollars.

Frequently Asked Questions: Streamlining Virtualist Credentialing

1. How long does the traditional physician credentialing process take?

In a traditional healthcare setting, the credentialing process typically takes 90 to 120 days. This timeline includes manual primary source verification (PSV) for education, board certifications, and malpractice history, followed by a 30-60 day review period from each individual insurance payer.

2. How can health systems reduce physician onboarding time to 60 days?

Health systems can cut onboarding by 30% (30 days) by leveraging pre-verified physician networks like DirectShifts. By utilizing clinical data that is already vetted—including verified licenses, background checks, and documented Epic EMR experience—the manual "collection phase" is bypassed, allowing payers to begin their review weeks earlier.

3. What is the financial cost of a 30-day credentialing delay?‍

30-day delay for a single virtualist costs approximately $24,000 in missed revenue, based on an average of 12 patients per day at $100 per visit. For a health system hiring a team of three virtualists, a 90-day bottleneck results in over $216,000 in lost revenue, not including the high cost of overflow "transactional" telehealth vendors.

4. Why is "pre-verification" critical for multi-state virtual care programs?

Multi-state operations multiply the administrative burden; one physician may require credentialing with 10+ separate payers across different states. Pre-verification ensures that all 10+ applications are submitted with "audit-ready" data simultaneously, preventing the fragmented delays that typically occur when managing 50-state compliance manually.

5. Can virtualist onboarding be accelerated for physicians without Epic experience?

While Epic experience is the "gold standard" for immediate productivity, onboarding can still be accelerated through demonstrable EMR competency. As Dr. Lyle Berkowitz notes, "Chance favors a prepared mind." Hiring physicians who are pre-screened for technical adaptability can reduce the "Epic ramp-up" from 8 weeks to 4 weeks.

6. What are the "hidden costs" of slow physician credentialing?

Beyond direct revenue loss, slow credentialing causes:

• Staff Burnout: Existing physicians must absorb the patient overflow.
• Contract Markups: Systems often pay a 40% markup to external staffing vendors to fill the gap.
• Recruitment Churn: Candidates often back out of offers if the credentialing process feels "broken" or takes longer than four months.