Invest in Your Workforce with a Strategic Shift to Expert Partnership
The decision to partner with a vendor for credentialing and enrollment can often be disconcerting, and many healthcare organizations face a common crossroads. The in-house operations team is strapped for time, already at capacity and unable to handle the volume of providers waiting to onboard. Or, the amount of credentialing files to process or enrollment applications to complete. Despite these challenges, they may have been disappointed by vendor performance or are hesitant to give up control of their process. Additionally, many organizations incorrectly assume outsourcing means they need to get rid of their current team.
The risks of keeping credentialing and enrollment in-house
Added costs due to operational staff turnover
Managing an in-house credentialing team means bearing the financial burden of recruiting, training, and retaining staff. High turnover rates can lead to inconsistent workflows, increased labor costs, and disruptions in credentialing processes—and hiring for operations roles is notoriously difficult.
Revenue delays due to credentialing & enrollment backlog
An overburdened in-house team often struggles to keep up with the demand, leading to backlogs. These delays can significantly impact your organization's revenue cycle, resulting in lost revenue opportunities and strained payer relationships. According to the MGMA, a single day of delay can cost a medical group $10,122 in lost revenue.
Human error leading to application rejections and compliance risk
Credentialing and enrollment require meticulous attention to detail. In-house teams, especially when understaffed or overwhelmed, are prone to making errors that can result in application rejections, costly compliance fines, and potential damage to your organization's reputation.
What can your team do with their extra time?
Outsourcing doesn’t mean letting go of your team—it means empowering them to do more impactful work. Successful organizations have seen the benefits of reallocating their talent to focus on strategic initiatives:
Managing credentialing & enrollment software
What this looks like:
Working closely with Medallion’s team and participating in regular reviews to ensure that immediate action items and strategic goals are met.
Utilizing Medallion’s CVO platform to report and monitor all provider workflows, validating key deliverables such as completed profiles, credential files, and payer enrollments while also tracking performance metrics like TATs and SLAs.
Ensuring that all supporting documentation in provider profiles is complete and accurate, helping to resolve any blockers and escalating priority issues when necessary. Manage the initiation of service requests.
Provider relations & satisfaction
What this looks like:
Hosting onboarding sessions with all incoming providers to walk through processes and Medallion relationships.
Building stronger relationships with providers through regular check-ins and feedback loops.
Addressing and resolving provider concerns more swiftly and effectively.
Implementing initiatives to improve provider experience and reduce administrative burden by cross-training and pivot resources to other areas that may need additional support.
Risk management and compliance audits
What this looks like:
Conduct regular provider directory audits, ensuring providers reflect in directories correctly and that terminated providers are being removed appropriately.
Address data integrity issues that need attention.
Creating and/or updating training documentation and standard operating procedures.
Outsourcing doesn’t mean giving up control
Outsourcing your credentialing and enrollment processes to Medallion doesn’t mean relinquishing control—it means enhancing it. With Medallion, you gain greater insight and full transparency, empowering you to maintain oversight and make informed decisions. Our platform provides real-time visibility at every stage of the credentialing process, ensuring you're always in the loop. Through step-by-step request tracking, you'll have clear timelines, automated notifications, and clickable access to payer follow-up emails, allowing you to monitor progress with precision.
The ROI you may be leaving on the table
There are four main pieces to consider when you think about the ROI of outsourcing: expertise, provider-to-FTE ratios, lost revenue, and hiring. Assessing these factors for your organization put you in the driver seat to look at the cost of building or expanding in-house versus finding a partner who can support your plans.
Use the ROI modeling tables below to calculate different ways you can generate more savings for your organization:
The results other healthcare organizations have achieved by outsourcing to Medallion
The results healthcare organizations like Family Care Center and Tampa General Hospital have achieved by outsourcing to Medallion are transformative. By moving away from inefficient in-house processes, organizations have significantly reduced operating costs and shortened credentialing timelines, allowing providers to begin seeing patients more quickly. This efficiency has not only enhanced service quality but also freed up valuable resources, enabling a stronger focus on patient care. As a result, these organizations have gained a competitive edge, positioning themselves to adapt rapidly to market demands while ensuring their clinicians and patients receive the highest standard of care
