Before the First Patient: The Hidden Hours Behind Every Network Clinician

November 12, 2026

| By: Alex Ding, M.D., MBA

Credentialing, enrollment and recredentialing protects patients and support trusted networks. New DataSpring research puts numbers behind the practice time these processes require and shows where more accurate, complete provider information would reduce delays.

Before a clinician can see patients as part of a health plan’s network, the plan must confirm who that clinician is, whether they are qualified to practice, and where they practice. This begins with credentialing and enrolling with a health plan, and continues through recredentialing, with each step serving a distinct purpose. Credentialing verifies qualifications. Enrollment sets the contract terms that make care covered and billable. Recredentialing confirms, at least every three years, that the information on file is still accurate.¹

Together, these steps keep unqualified or sanctioned clinicians out of the networks patients rely on.

As a practicing physician, I see credentialing as the point where years of training translate into a patient’s access to care. A newly hired physician may have an open schedule and be ready to practice, while patients with a particular health plan still wait for that physician’s network participation to begin due to a slow credentialing process.

The hours add up across a practice

DataSpring, powered by CAQH, surveyed over 50 clinical and administrative practice staff what this work looks like from the inside. The insights are published in our latest Pulse Credentialing Issue Brief.

Practices report spending an average of 502 hours a year on initial credentialing and enrollment, nearly two months of staff time. Recredentialing clinicians already in network takes another 592 hours a year. Combined, that is roughly half a full-time position devoted to getting clinicians into networks and keeping them there.

Per clinician, per plan, initial credentialing and enrollment takes about 18 hours, more than two full workdays. Recredentialing takes about 5 hours and repeats for as long as the relationship lasts. That recurring cycle is why recredentialing ends up as the larger annual commitment.

Among survey respondents, 69% said they personally handle credentialing tasks, and only 8% reported using a vendor. Whether clinicians or administrative staff manage the work, it draws on the same limited practice capacity needed to support patient care.

When information is wrong, the process stops

60% of respondents say initial credentialing or enrollment has been delayed or denied because information was inaccurate or missing. Only 24% say that has never happened.

Sixteen percent of respondents could not say whether inaccurate or missing information had affected their credentialing or enrollment. That uncertainty leaves part of the picture unresolved. A practice may know an application was denied without knowing what is slowing another: a license number, address or taxonomy code may need reconciliation while the practice sees only elapsed time.

These delays carry real consequences. A November 2025 MGMA Stat poll found that about a third of medical groups had a backlog in credentialing, recredentialing, or reappointments, most often tied to payer enrollment and verification.² In a 2025 industry survey, 60% of executives said slow enrollment processes hurt revenue.³ With average annual net revenue of approximately $2.4 million per physician across 19 specialties,⁴ each working day a clinician is on payroll and unable to bill represents roughly $9,000 in lost opportunity cost.

For patients, a delayed enrollment can mean a clinician missing from the directory or a longer wait for an appointment.

With average new-patient appointment waits now at 31 days in major metro areas, up 48% since 2004, every week a qualified clinician waits for network participation matters.⁵ Faster credentialing won’t close the workforce gap, but it gets clinicians to patients sooner.

The burden is heaviest where resources are thinnest

Plan requirements stay the same regardless of practice size. In practices with fewer than five clinicians, each clinician or staff member spends roughly seven times as many hours on initial credentialing and enrollment as a counterpart in a larger practice. MACPAC’s June 2026 Report to Congress reached a similar conclusion for Medicaid, finding the burden most acute for clinicians in small practices.⁶

The effect reaches clinicians personally. 77% of medical groups cite regulatory and administrative burden as a major contributor to physician burnout.⁷

A more coordinated path forward

The opportunity is to make trusted provider information usable across plans while preserving the careful verification that credentialing, enrollment and recredentialing require. Reducing unnecessary variation gives practices and plans a more coordinated way to complete that work. The issue brief outlines several practical steps:

Standardize the information collected and define what a complete application looks like
Verify information closer to its source and keep it current
Align the timing of credentialing, recredentialing, and directory verification to reduce repetitive burden

The measure of progress is straightforward: more time for patient care, a more efficient path into networks and greater confidence that the clinician a patient finds is ready to see them. A more coordinated approach to provider information must be judged by those outcomes.

Download DataSpring’s Pulse Credentialing Issue Brief to explore the full findings and methodology.

Sources

Before the First Patient: The Hidden Hours Behind Every Network Clinician

The hours add up across a practice

When information is wrong, the process stops

The burden is heaviest where resources are thinnest

A more coordinated path forward

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