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The reality of automation in payer enrollment and credentialing workflows (new research)

Automation is no longer a futuristic concept — it's here. It’s rapidly reshaping how we approach healthcare, from patient care to administrative tasks. To better understand how healthcare organizations are prioritizing automation and actively shaping their future with it, Medallion conducted a survey of nearly 350 healthcare specialists, managers, directors and C-suite executives in the U.S.

We found a glimpse into the challenges enrollment and credentialing teams face: manual workflows, budget restraints and turnover. The answers were varied but one thing was clear — many teams are optimistically looking ahead to a future where innovative and efficient practices are embraced. 

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The current state of payer enrollment and credentialing is marked by awareness and optimism

If there was one takeaway from all the data collected by Medallion, it’s this: Operations teams are facing high turnover and inappropriately low staffing levels, yet realize they need to cut headcount expenses.

40% of those surveyed say their enrollment workflows are entirely manual. And, 52% say their credentialing workflows are entirely manual. Despite these challenges, optimism and a desire for automation is strong: 53% of our respondents say automating and creating more efficient processes are top priorities for them this year.

Organizations feel strained and see a direct impact on revenue

46% of respondents reported revenue impacts due to unoptimized enrollment workflows and slow turnaround times. The existing long timelines for payers to process claims and remit reimbursements — often stretch between 90 to 120 days — due to slow, manual workflows. 

It’s not necessarily surprising that many teams still rely on manual workflows, but there’s an incredible opportunity for automation to alleviate much of this burden.

And in credentialing, 84% of these teams experience end-to-end turnaround times of 15 days or more. As Medallion notes in the report, the demand for healthcare services is outpacing the supply of providers leaving healthcare organizations in a critical moment: The need to simplify credentialing processes so providers can focus more on care and less on paperwork, and healthcare organizations can grow.

What comes next

One of the goals of the survey was to shed light on how enrollment and credentialing professionals feel when it comes to their work and on what processes they spend the most time on. 

What we found is a world where healthcare teams navigate the complexities of enrollment and credentialing with dedication yet the toll of manual processes is undeniable.

With the U.S. healthcare sector spending over $800 billion annually on administrative costs, pushing for operational efficiency isn't just a goal — it's necessary for scaling and sustaining financial health. Here is where the power of automation can support teams and their organizations.

Click here to download the report →