- OnCall Solutions Editorial Team
- Published:
- Updated: August 2026
The short answer
Physician credentialing typically runs 90 to 120 days, and every one of those days is clinical capacity your hospital already paid to recruit but can’t deploy. Stack that on top of a median 118-day physician search, and the gap between “we need a hospitalist” and “the hospitalist sees patients” stretches past seven months. Hospitals close that gap three ways: digital credentialing platforms, Interstate Medical Licensure Compact licensure, and pre-credentialed locum coverage running in parallel with the permanent hire.
Credentialing, privileging, and payer enrollment are three different clocks
Most conversations about credentialing delays go sideways because the participants mean three different things. Sorting them out is the fastest way to find where your own timeline actually breaks.
Credentialing is primary source verification. Someone confirms directly with the issuing body that the medical school, residency, board certification, state license, the DEA registration, and the malpractice history are what the CV says they are. NCQA accredits organizations doing this work, and its standards define what counts as an acceptable verification.
Privileging is your medical staff office and credentials committee deciding which specific procedures this verified clinician may perform at your facility. It happens after credentialing and runs on the committee’s meeting calendar, which is why a file that clears verification on the 3rd can still wait until the 20th.
Payer enrollment is getting the clinician into Medicare, Medicaid, and commercial plan networks so their work generates collectible revenue. It runs on its own timeline, often longer than credentialing, and it’s the one hospitals discover late.
A physician can be fully credentialed, fully privileged, and still not billable. If your onboarding tracker has one field called “credentialing,” you’re measuring one of three clocks.
What a credentialing delay actually costs
Here’s the number most hospitals never put on paper. The most recent Merritt Hawkins physician revenue survey found that physicians generate an average of $2,378,727 a year in net revenue for their affiliated hospitals. Divide that across a year, and you get roughly $6,500 a day. In a 100-day credentialing window, that’s about $650,000 in clinical activity a hospital has recruited, hired, and budgeted for but can’t yet capture.
Two honest caveats. That survey dates to 2019, which is the most recent edition Merritt Hawkins has published, so treat it as directional rather than current. And a delayed physician’s panel doesn’t vanish; some of that work gets absorbed by colleagues, converting revenue loss into workload. That conversion is the whole problem. You either lose the revenue, or you spend your existing team to keep it.
The credentialing fee itself is the smaller number. MedWave, a credentialing services firm, puts the process cost at roughly $7,000 to $8,000 per provider and the average timeline at 90 to 120 days. Those are vendor figures rather than audited benchmarks, and no independent body publishes a national credentialing timeline, so we cite them as what the credentialing industry reports about itself.
The most common causes of credentialing bottlenecks
Credentialing teams often carry hundreds of files at once, and small errors cause outsized slowdowns. Four causes account for most of the lost time:
- Incomplete or inaccurate documentation. A one-month gap in a CV or a lapsed malpractice certificate triggers a full re-verification cycle, and the file goes back to the end of the queue.
- State-by-state licensure barriers. Every state board sets its own verification, background check, and fingerprint requirements, which extend multi-state onboarding timelines.
- Manual data entry and outdated systems. Hospitals still running verification through spreadsheets and fax post the longest turnaround times, and every manual re-key is a chance to introduce the discrepancy that starts a re-verification cycle.
- Administrative staffing shortages. Lean medical staff offices create backlogs, and backlogs burn out the exact team you need moving faster.
The documentation problem is the one hospitals control most directly and address least often. In Medallion’s 2024 State of Payer Enrollment and Credentialing survey, 57% of respondents said they often or sometimes go back to a provider for additional information after an application is already underway. That survey covers payer enrollment rather than hospital privileging, but the failure pattern is the same one medical staff offices describe, and every round trip adds days.
For clinicians preparing on the other side of this process, our locum tenens assignment documents checklist lists what to assemble before an application opens. Front-loading that paperwork is the cheapest way to prevent delays on either side.
Cost Comparison: Overtime versus Flexible Coverage
When credentialing stalls, hospitals choose between pushing existing staff into overtime and bringing in short-term clinical support. Both cost money. Only one compounds.
| Scenario | What it looks like | Estimated 90-day cost | Where the risk sits |
|---|---|---|---|
| Overtime coverage | Employed physicians and APPs absorb open shifts while the new hire clears credentialing | $15,000 to $25,000 per clinician in added payroll (OnCall Solutions estimate) | Burnout, absenteeism, and turnover in a team you already have |
| Flexible staffing | Credentialed locum or interim clinicians cover the same window through a staffing partner | $18,000 to $22,000 depending on specialty, contract length, and market (OnCall Solutions estimate) | Contract cost is known upfront and ends when the hire starts |
| Leaving shifts uncovered | Reduced schedule, diverted volume, longer waits | Roughly $6,500 per day in foregone physician revenue (illustration based on the 2019 Merritt Hawkins survey average) | Patient access and referral relationships |
Three Proven Ways to Streamline Provider Credentialing
1. Use digital credentialing platforms to reduce manual errors
Credentialing software automates primary source verification, flags missing fields before submission rather than after, and maintains a single provider profile across multiple facilities. Platforms like Credentially and Modio Health are built for this, and most integrate with CAQH ProView so providers aren’t re-entering the same data for every application.
Vendors claim large gains. MedWave reports that average time to credential drops 30 to 50% for organizations working with an experienced outsourcing partner. That’s a vendor describing its own category, so weigh it accordingly. The underlying mechanism holds up regardless: automation removes manual re-keying and incomplete submissions, the two things that cause re-verification cycles.
2. Take advantage of the Interstate Medical Licensure Compact
The IMLC gives eligible physicians an expedited route to licensure across participating states. As of August 6, 2026, the Compact spans 44 member states plus two US territories and 59 licensing boards, and has issued 227,966 licenses since it launched.
On speed, the AMA reports that obtaining a Letter of Qualification takes about 38 days, and that 55% of physicians get one in under one month. Once that letter is in hand, additional state licenses come much faster than applying to each board independently, because the duplicate primary source verification is already done.
Two things to know before you plan around it:
- Eligibility is restrictive: physicians need a full unrestricted license in a member state, an accredited medical school and ACGME or AOA training, and a clean disciplinary and criminal record.
- An IMLC license is state licensure only. It does nothing for your hospital privileging timeline. Screen for IMLC eligibility during recruitment rather than after the offer letter, and you convert it from a nice surprise into weeks of saved calendar.
3. Partner with a physician staffing agency to run coverage in parallel
Physician and APP staffing agencies maintain active networks of pre-vetted, already-credentialed clinicians. That lets a hospital cover an urgent gap while the permanent hire moves through credentialing at whatever pace it takes.
The shift is conceptual as much as operational. A 100-day credentialing window stops being 100 days of uncovered shifts and becomes 100 days of covered shifts running alongside a verification process. Our breakdown of how hospital staffing partners simplify medical credentialing walks through how the verification work transfers and what stays with your medical staff office.
Cost ranges in rows one and two are OnCall Solutions planning estimates drawn from typical 90-day coverage engagements, not published benchmarks. Actual cost varies widely by specialty and market.
The sticker prices in the first two rows land close together, which is exactly why this comparison gets made badly. The difference shows up after day 90.
Turnover is where the overtime path gets expensive. The 2026 NSI National Health Care Retention and RN Staffing Report puts the average cost of turnover for a staff RN at $60,090, with the average hospital losing $5.19 million a year to RN turnover alone. Physician replacement costs run substantially higher, since you’re restarting an 118-day search and a 100-day credentialing cycle at the same time.
Burnout is trending the right way. The AMA found physician burnout at 41.9% in 2025, down from 43.2% in 2024 and 48.2% in 2023, across nearly 19,000 responses. Four straight years of improvement is real progress, and covering credentialing gaps with sustained overtime is a direct way to give it back. We covered that tradeoff in how locum tenens helps reduce physician overtime.
How to Integrate Credentialing into a Faster Onboarding Process
Credentialing works best connected, not isolated. Run as its own silo, gaps open between HR, the medical staff office, and department leaders, and nobody owns the handoff. Four moves close them:
- Build a shared checklist with named owners for every task, split across HR, the medical staff office, and the department lead.
- Use EHR-integrated tracking so provider profiles sync across departments instead of living in one coordinator’s inbox.
- Start payer enrollment in parallel, not after privileging clears, so the billing clock isn’t waiting on the privileging clock.
- Assign an onboarding coordinator who owns each clinician from signed offer to first shift.
The coordinator role is the one hospitals cut first and miss most. Credentialing rarely stalls because a step is unknown. It stalls because no single person is accountable for the space between two steps, and files sit in that space for weeks without anyone noticing.
Frequently asked questions
How long does physician credentialing take?
Credentialing providers consistently report 90 to 120 days per physician. Privileging and payer enrollment can add more time on top of that.
Does the IMLC replace hospital credentialing?
No. The Compact expedites state medical licensure only. Your hospital still performs its own credentialing and privileging.
How fast is an IMLC Letter of Qualification?
The AMA reports 38 days on average, with 55% issued in under a month.
Can a locum cover a role while a permanent hire is being credentialed?
Yes. Staffing partners place clinicians who are already credentialed, so coverage and credentialing run in parallel rather than in sequence.
What's the difference between credentialing and payer enrollment?
Credentialing verifies a clinician’s qualifications so they can practice at your facility. Payer enrollment gets them into insurance networks so their work is billable. A physician can be fully credentialed and still not billable.
The Bottom Line: Faster Credentialing Means Stronger Staffing
Credentialing delays cost hospitals money and momentum, and the money is more than the credentialing budget suggests. Modernizing the systems, screening for IMLC eligibility during recruitment rather than after it, and bringing in a partner who can cover the window turns a fixed 100-day loss into a managed one.
When hospitals work with OnCall Solutions, credentialing support comes as part of a complete onboarding framework. Our teams make sure clinicians arrive fully licensed, verified, and ready to see patients on day one.
Facing a credentialing gap right now? Talk to OnCall Solutions about coverage while you credential.
Prefer to see how it works first? Start with our locum tenens staffing for hospitals overview.