The 2026 State of Provider Credentialing for Payers

Payers face rising pressure as provider credentialing teams manage expanding networks, stricter regulatory expectations, and ongoing staffing shortages. This report highlights the most common breakdowns and trends to modernize processes to strengthen reliability and reduce cycle times.

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Honestly, I feel like payer enrollment and provider credentialing are kinda stuck between old-school methods and a world that’s moving super fast. A lot of places are still doing things the hard way [with] too much paperwork, too many emails, and way too many steps that could’ve been simplified years ago."

Kenickay Prendergast
Provider Specialist at Provider Network Solutions

The breakdowns hindering cost-efficient credentialing infrastructure in 2026

How are staffing shortages impacting provider credentialing performance?

Burnout is the top staffing challenge for payer organizations: 30% of plans cite admin burnout. Smaller health plans more often struggle to hire experienced credentialing talent. These shortages slow onboarding and create audit exposure when compliance steps are missed due to capacity constraints.

Where are payers investing in AI to improve credentialing?

Payers are directing the most AI investment toward provider credentialing and directory management (21%). The ROI is clear: automation accelerates time-to-network and strengthens provider experience — two critical levers for meeting access-to-care requirements and improving member satisfaction.

What’s slowing AI and automation adoption for payer credentialing teams?

The biggest barriers are legacy system integration (20%) and limited internal AI expertise (18%) — a readiness gap, not a lack of interest. Teams want automation, but many need ready-to-run solutions that minimize implementation burden and technical lift.

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