5 Common Credentialing Mistakes That Cost Therapy Practices Revenue
Credentialing might not be the most exciting part of running a therapy practice, but getting it wrong is one of the fastest ways to lose revenue. We've worked with hundreds of OT, PT, and speech therapy practices, and the same credentialing mistakes come up over and over. Here are the five most common ones and how to avoid them.
1. Starting Credentialing Too Late
This is by far the most common and most costly mistake. Many practices wait until a new provider's start date is approaching before beginning the credentialing process. By that point, you're already behind.
Most commercial payers take 60-120 days to process credentialing applications. Medicare takes 45-65 days. That means if you start credentialing on your new PT's first day, you could be looking at 2-4 months where they can see patients but you can't bill their insurance. Our credentialing timeline guide breaks down what to expect payer by payer.
The fix: Start the credentialing process at least 90-120 days before a new provider needs to see patients under insurance. Begin gathering documents and setting up their CAQH profile during the hiring process.
2. Letting CAQH Attestation Lapse
Your CAQH ProView attestation expires every 120 days. When it lapses, payers can't access your provider's profile, and any pending or future credentialing applications grind to a halt.
We see this happen frequently with practices that set up CAQH once and then forget about it. The provider's profile looks complete, but because attestation expired, payers treat it as incomplete.
The fix: Set recurring calendar reminders to re-attest every 90 days. Review the full profile each time you attest to catch any outdated information — our CAQH profile setup guide covers what to check. Better yet, use a tracking system that monitors attestation deadlines automatically.
3. Not Tracking License and Certification Expirations
A lapsed license or expired certification doesn't just create a compliance problem. It can result in retroactive claim denials. If a payer discovers that a provider's license was expired when services were rendered, they can and will take back payments.
This hits therapy practices particularly hard because each discipline has its own set of credentials to track: state licenses, board certifications (NBCOT, ABPTS, ASHA CCC), CPR/BLS, malpractice insurance, and more. The specifics differ by discipline — see what gets tracked for occupational therapy, physical therapy, speech therapy, ABA therapy and pediatrics.
The fix: Maintain a centralized tracking system for every provider's credentials with automated alerts well ahead of expiration dates. Don't rely on individual providers to track their own renewals. The practice needs a system-level view.
4. Submitting Incomplete Applications
Incomplete credentialing applications are the single biggest cause of processing delays. A missing signature, an outdated document, or an incorrect NPI number can add weeks or months to the timeline.
What makes this especially frustrating is that many payers don't proactively notify you about issues. Your application just sits in a queue until you follow up and they tell you what's missing.
The fix: Before submitting any application, run through a checklist of required documents and information. Verify that every field is complete, all signatures are present, and all supporting documents are current. Keep a copy of everything you submit with a timestamp.
5. Failing to Follow Up
Credentialing applications don't process themselves. Even complete, accurate applications can get stuck in a payer's queue. Without regular follow-up, an application that should take 60 days can stretch to 120 or more.
Many practice administrators submit applications and then wait to hear back. By the time they check in, months have passed and the application may have been lost, assigned to a different department, or deprioritized.
The fix: Follow up with every payer every 2-3 weeks after submitting an application. Document every interaction including who you spoke with, what they said, and any reference numbers. This creates an accountability trail and keeps your application moving.
The Revenue Impact
These five mistakes compound. A practice that starts credentialing late, has CAQH issues, and doesn't follow up can easily lose 3-6 months of billing for a new provider. For a busy therapist seeing 8-10 patients per day, that's tens of thousands of dollars in lost revenue.
The practices that avoid these problems are the ones that treat credentialing as an ongoing operational process rather than a one-time task. They have systems in place to track deadlines, monitor application status, and ensure nothing falls through the cracks.
Credentialing Now gives therapy practices the tools and workflows to avoid all five of these mistakes. From automated expiration tracking to centralized application management, we help ensure your credentialing runs smoothly and your revenue stays on track. See pricing or browse credentialing by specialty.