ROI: Demonstrating the Value of Excellent Credentialing and Privileging

ROI: Demonstrating the Value of Excellent Credentialing and Privileging

Jul 10, 2019
  • Author:
    Lara Abramov
    Former VerityStream Employee

This blog post is based on a webinar presented by Mark Westbrook, Sr. Director of Client Success Services Consulting and VerityStream PMO and Jonas Fridrichsen, Chief Revenue Officer at VerityStream

Ever wonder how to convince your organization’s executives to invest in a new software solution? One that saves time and money while increasing Provider satisfaction?

Convincing your leadership is possible if you know what types of information to present. Identifying the areas your organization can save time and money is easy to do – if you know what elements to analyze and present.

Aside from ensuring patient safety, your credentialing and privileging process plays a vital role in improving the health of your bottom line. While identifying the many ways an efficient credentialing and privileging solution can save you money, did you know it could generate revenue for your organization?

How? Let’s walk through the steps.

Writing a business case

Being able to justify expenditures is crucial to developing a business case. In any organization, there are always competing funding priorities and budgets. Additionally, it doesn’t help that all funding requests promise positive results.

With just these two factors in mind, it’s easy to understand what your leadership is contending with and why it’s so important to have a strong business case that:

  • Piques the interest of your readers
  • Outlines the benefits of an investment
  • Quantifies the value of the credentialing and privileging process
  • Measures the achievement of your ROI

Often, talking with others in your organization can be helpful when writing a business case. Folks on your IT, Project Management and Business Analyst teams are a great source of information. Aside from providing specific information, they may also have tips on formatting and presenting business cases in your organization.

Where to look for ROI

So, you understand the foundational components of your business case – it must be engaging, outline the benefits, provide quantitative data and ways to measure your goals.

But, in a medical staff office, what elements of the credentialing and privileging process should you focus when determining ROI? How will investing in a new credentialing and privileging solution financially impact your office?

We’ve identified six areas your medical staff office can look to when defining your return on investing in an automated credentialing and privileging solution:

MSO efficiency

Automation and electronic processing makes your office run smoother


Increased efficiency means fewer staff needed, though there are often plenty of other initiatives staff can work on

IT Support

Consolidation, standardization and cloud-based solutions save time and money

Office Space

Fewer servers and files mean less office space

Office Supplies

Automation and electronic processing means less paper and fewer filing cabinets

Practicing & Billable Providers

Getting your providers practicing faster generates revenue

While several of the items above, such as office supplies or space, provide smaller savings, revenue generation is primarily realized by reducing the length of time between hiring providers and obtaining the approvals needed to deliver billable services.

To define your ROI looking at only this opportunity – getting your healthcare professionals billable faster – you must:

  • Have a clear understating of current turnaround times
  • Determine how many days you want to reduce turnaround times by
  • Commit to regularly monitoring your turnaround times

Getting your providers on the floor faster not only generates revenue, it improves provider satisfaction and can attract other healthcare professionals to your practice.

How to calculate ROI

As the majority of your revenue is derived from providers delivering billable services, there’s a formula to determine the ROI on credentialing and privileging new applicants. Reappointments are generally conducted on a rolling basis; new applicants are where the real revenue generation opportunities lie.

Here’s how to calculate your ROI on credentialing and privileging new applicants:

  • Determine how many new applicants are processed each year
  • Estimate conservative daily revenues generated by new physicians
  • Set a target reduction turnaround timeframe

To estimate revenue generated daily by new physicians, you can turn to a national survey, such as the Merritt Hawkins. However, it’s often more beneficial to get those figures directly from your finance team.

Let’s look at the example below:

New applicants per year:


New physicians daily revenue generation:


Reduce turnaround time by ten days:


Reduced turnaround x 100 new applicants:

$1,000,000 per year in revenue generation!

How VerityStream helps determine your ROI

Effectively capturing savings and generating money through your ROI requires investment from your leadership team, the people and technology to make change happen and a willingness to change.

To help further your conversations, VerityStream has created an ROI Calculator. It’s easy to use, and, once completing, a VerityStream Adviser will walk you through the analysis. They’ll explain just how much money your organization can save and make using an automated credentialing and privileging process.

Stop wasting time and money and improve provider satisfaction by investing in an automated credentialing and privileging solution today!