Expedited Credentialing

An accelerated credentialing process offered by some payers for providers in high-demand specialties, underserved areas, or urgent staffing situations.

Expedited credentialing is a faster pathway through the enrollment process that some payers offer in specific situations. Instead of the standard 60 to 120 day timeline, expedited credentialing can be completed in as little as 14 to 30 days. Payers typically offer expedited processing in these situations: the provider is replacing a departing provider and patients need continuity of care, the provider is in a specialty where the payer has a network adequacy gap, the provider is serving an underserved geographic area, or there is an urgent public health need. CMS offers expedited Medicare enrollment for certain provider types and situations. Physicians and non-physician practitioners can receive temporary enrollment in disaster situations. Some MACs offer expedited processing for providers establishing new practices in areas with provider shortages. To request expedited credentialing, you typically need to make the case to the payer's provider relations or credentialing department. Explain why expedited processing is warranted, provide documentation of the urgency, and have all your application materials ready for immediate submission. A complete, error-free application is essential because expedited processing does not mean they skip steps. They just do the same steps faster. Some large medical groups and health systems have negotiated blanket expedited credentialing agreements with payers. If the group has delegated credentialing authority, new providers can start seeing patients almost immediately after the group approves their credentials, while the payer processes the formal enrollment in the background. Do not assume expedited processing is available. Ask before you apply. And do not wait until you are in a staffing crisis to discover that the payer does not offer it. If you anticipate needing a provider quickly, have the conversation with the payer early and start the application process before the need becomes urgent. Even with expedited processing, your application still needs to be complete and your credentials still need to be verified. The verification just happens faster, sometimes with same-day turnaround instead of the usual weeks.