Lost provider capacity is unrecoverable revenue, and you can feel it most when many plan-year deductibles reset in January. If a provider isn't recredentialed or enrolled, those unfilled slots become unbillable days. And from October to December, primary source verification (PSV), NPDB, and sanctions checks stack up, which can be especially grueling if your practice is targeting a January start date for a new physicians or APP.  

Late-year file completions, privileging sign-offs, and payer enrollment can all hit at once, alongside holiday slowdowns, fewer committee meetings, and credentials verification organization (CVO) workloads peaking nationwide. 

A Nov. 4, 2025, MGMA Stat poll found that nearly two out of three (65%) medical groups report their provider files — for new-hire credentialing, payer recredentialing, and reappointments — are on time, while 32% report some type of backlog (23%), CVO delay (3%), or slip that will result in completion in Q1 (6%). Another 3% responded “other.” The poll had 131 applicable responses. 

Groups that stayed on time pointed to enough staff, a clear checklist, a bit of automation, and holding CVOs to written turnaround targets (SLAs).  

In the practices with some form of delay, backlogs mostly traced to payer enrollment delays and slow references/board verifications, compounded by thin staffing or disorganization and slow turnarounds (often by third-party vendors). Seasonal pressures (holidays, end-of-year push), provider responsiveness, and missing data/doc requests round out the main stall points. 

Did you know? 

MGMA members receive a 20% discount when they use MGMA Credentialing, powered by ProCred. 

What to watch like a hawk 

A few simple leading indicators give you early warning before files stall: 

• Oldest file in the queue: The best early warning your process is slowing down. 
• PSV turnaround days and items on hold (references, board letters, hospital affiliations). 
• Committee schedule basics: Make sure the Credentials Committee/MEC has quorum, backup dates, and gets the packet on time. 
• Payer enrollment in progress: submissions sent, effective dates requested/returned, pending re-enrolls. 
• For CVOs and managed service organizations (MSOs) with established expectations, track whether they’re meeting the SLA and how many files are waiting. 

Make these visible so they can be reviewed every week between Halloween and mid-January. If you have only a few people who touch credentialing, a five-minute huddle works; the goal is to spot issues early and jump on them. 

4 moves for staying on time in crunch season 

1. Plan backward from the date privileges must be signed, not when you uploaded documents. Establish a working deadline for signed approvals (e.g., Dec. 10) and back up each prerequisite with buffers. Files rarely slip because a form wasn’t uploaded; they slip because the decision meeting wasn’t set or the committee packet landed too late. 
2. Create an “access-ready” milestone (IT setup, schedule built). For new hires, define a mid-way state that allows template building, schedule holds, IT provisioning, and orientation to proceed while payer enrollment and final signatures finish. Label it clearly: “access-ready” does not mean “billable-ready.” 
3. Hold a quick risk huddle. Keep the focus on the handful of files that put January access at risk. Name the single next unblocker for each — “Dean’s letter ETA,” “PSV for hospital #2,” “payer effective date adjustment” — and assign an owner. A 15-minute effort like this can yield quick wins, even when an office manager also wears HR and front-desk hats. 
4. Work with vendors/CVOs early and often. Ask for current oldest-file age, number of files lagging, and the plan to clear them. Escalate with specifics. You don’t need an audit — just a shared tracker and someone who flags your files before they stall. 

A quick word on technology 

If you’re using a CVO or an enrollment service, ask for a simple, shared tracker that shows SLA status, how many files are waiting, and your oldest file. If you manage in-house, a basic task tool usually beats a large spreadsheet once you exceed a handful of providers. Small automations (pre-filled PSV requests, missing-document alerts) save hours you can spend on the tricky files. 

MGMA resources to help 

• Physician Credentialing Checklist — A practical, end-to-end list to organize new-physician credentialing. 
• Provider Privileging Checklist — Documentation and process essentials for privileging. 
• “Navigating the credentialing gauntlet: Key actions for RCM” — Practical guidance on aligning credentialing with cash flow. 
• On-demand webinar: “Navigating physician credentialing in medical practices” — A deeper dive into in-house vs. outsourced models and process pitfalls. 

Join MGMA Stat  

Our ability at MGMA to provide great resources, education and advocacy depends on a strong feedback loop with healthcare leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit mgma.com/mgma-stat. Polls will be sent to your phone via text message.