📜 Credentialing Headaches? When to Bring in Legal Help

Credentialing should be straightforward, right? You submit your paperwork, wait a bit, and boom—you're in-network.

But for many providers, the credentialing process becomes a months-long slog filled with delays, denials, and dead ends.

Here’s when a healthcare attorney can help speed things up—and protect your rights in the process.

🚩 Common Credentialing Issues

• Lost or incomplete applications

• Unexplained delays from payors

• Being stuck in “pending” status for months

• Claims denied as “out of network” even after approval

• Unfair terminations or re-credentialing denials

📉 The Cost of Delays

When you’re not credentialed:

• You may be working for free

• Patients may leave your practice

• Your reputation with payors can suffer

• It can create cash flow issues quickly

🧑‍⚖️ How a Lawyer Can Help

• Push back on improper denials or delays

• Ensure you receive written reasons for any termination

• Challenge credentialing errors under applicable state laws

• Help you appeal network participation decisions

• Negotiate favorable contract terms once you're approved

⚖️ Know Your Rights

In many states, payors must:

• Decide credentialing applications within 90–180 days

• Provide written notice of terminations

• Offer an appeals process

If they don’t? You may have grounds for a formal provider complaint or legal claim.

🧠 Final Word

Credentialing can feel like a black hole, but you don’t have to go it alone. If delays are dragging on or communication has stalled, a legal nudge may be what’s needed.

Let’s get you credentialed—and compensated.

📧 eric@hurleylawgroup.com
🌐 hurleylawgroup.com
🗓️ Book a consult today!