5 Credentialing Benchmarks Your Organization Should Be Tracking in 2026

What Gets Measured Gets Fixed

Most healthcare organizations can tell you how many providers they have. Far fewer can tell you how long it takes to credential one, what percentage of their licenses are current, or how many exclusion list screens they ran last month. In my hospital credentialing role, I spent a significant amount of time building and maintaining tracking systems for exactly these things, and I can tell you that the organizations without benchmarks are the ones who find out about problems at the worst possible time: during an audit, a payer review, or a compliance investigation.

Here are five benchmarks that every credentialing program should track.

1. Time to Credential

This is the number of days from when a provider's completed credentialing application is received to when the provider is approved for appointment, privileging, or enrollment. Credentialing timelines can vary significantly depending on application completeness, primary source verification requirements, committee review schedules, payer processing timelines, and state-specific enrollment requirements.

Some delays are within the organization's control, while others are not. Internal delays may involve incomplete applications, missing documentation, reference follow-up, verification delays, or committee scheduling. External delays are often tied to payer processing timelines, enrollment backlog, contracting requirements, or state Medicaid enrollment processing.

Track this metric by provider, by payer, and overall. Separating internal organizational delays from external payer processing delays can help organizations identify bottlenecks, improve turnaround times, and better understand where the credentialing process is slowing down.

2. Renewal Compliance Rate

This is the percentage of provider credentials (licenses, certifications, DEA registrations, malpractice policies) that are renewed before their expiration date. The target is 100%, and anything below 95% indicates a gap in your monitoring and alert system. A lapsed credential can prevent a provider from practicing, billing, maintaining privileges, or participating with payers, and it can create significant compliance exposure for the organization.

Track this as a rolling metric. A single lapse in a year is understandable. A pattern of lapses is a systemic problem. In my experience, most lapses are not caused by negligence. They are caused by the absence of a reliable alert system.

3. Exclusion List Screening Frequency

If your organization bills Medicare, Medicaid, or any federal healthcare program, OIG recommends monthly screening against the LEIE to minimize overpayment and civil monetary penalty liability. [1] Many organizations also include SAM.gov and state exclusion databases as part of their routine exclusion screening process. Where applicable, track how frequently your organization runs exclusion screens across all active providers and document the results. This metric is one of the first things auditors examine, and it is one of the easier compliance processes to automate and monitor consistently.

4. Provider Satisfaction with Onboarding

This is the metric most organizations do not track and probably should. How do providers rate the onboarding and credentialing experience? Is it frustrating, confusing, or slow? Do providers have visibility into where they stand? A simple post-onboarding survey can surface problems that the credentialing team may not see from their side of the process. In a competitive healthcare environment, a poor credentialing experience can influence whether providers continue pursuing affiliation with an organization. Tracking satisfaction turns an invisible problem into a measurable one.

5. Cost Per Credentialed Provider

This is the total cost involved in credentialing a provider, including staff time, software costs, verification fees, contracted services, and the day-to-day administrative work that goes into managing the process. Costs can vary quite a bit depending on the organization's processes, payer requirements, staffing, and how much manual follow-up is needed to keep applications moving.

Automation can help reduce some of the administrative burden, especially when tracking expirations, reminders, and document management, but credentialing still requires a significant amount of oversight and follow-up.

Track this over time and look for patterns. Costs tend to increase when staff are spending large amounts of time on manual tracking, repeated follow-up, incomplete applications, missing documentation, and reworking files delayed by payer issues or processing delays.

Start Tracking. Start Improving.

Benchmarks are not just numbers on a dashboard. They help organizations identify problems earlier, understand where the delays are happening, and see whether processes are improving over time. If you are not tracking these metrics, it becomes harder to recognize issues before they turn into larger compliance or operational problems.

The good news is that organizations do not need complicated systems to start tracking these things. Even simple tracking processes and consistent follow-up can make a significant difference.

Platforms like CredNet can also help organizations centralize tracking, reporting, and analytics across these types of metrics.

Learn more at credentialnetwork.com.

References

[1] Office of Inspector General (OIG), U.S. Department of Health and Human Services. Updated Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs. May 8, 2013. View bulletin