How to Know If You’re Losing Revenue by Skipping Credentialing

carmen97815
May 14
1 min read

Imagine working long hours, seeing patients back-to-back, and still wondering where the money is going.If you’re running a medical or behavioral health practice without properly credentialing with payors—you could be losing thousands each month without even realizing it.

What Is Credentialing—and Why Skipping It Hurts

Credentialing is the process of verifying a provider’s qualifications and getting them approved to bill insurance companies. It’s not just a formality—it’s a requirement. If your providers aren’t credentialed with insurance networks, claims get denied, payments are delayed, or worse, you never get reimbursed at all.

Signs You’re Losing Revenue Due to Missing Credentialing

✅ You’re receiving frequent claim denials for “provider not enrolled” or “not in-network.”

✅ Patients with insurance are paying out-of-pocket or choosing other providers.

✅ You're stuck relying on superbills instead of direct payor billing.

✅ Your accounts receivable are growing—but your bank account isn’t.

Real Cost: One Provider, One Missed Panel

Let’s say your therapist sees 20 patients a week at $125 per session.That’s $2,500/week.If they’re not credentialed and can’t bill Aetna, UHC, or BCBS—that’s potentially $10,000/month slipping through your fingers.

The Fix: Credentialing Isn’t Just Paperwork—It’s Profit

At Sosa Practice Partners, we help providers avoid the stress, confusion, and lost income that comes from skipping or mishandling credentialing. Whether you're a solo therapist or a multi-provider group, our team manages the entire credentialing process—from CAQH setup to payor contracting—so you don’t miss a dollar.