At Cred2Bill, we see this as an important signal: credentialing is finally being recognized as a strategic backbone of healthcare operations. Its not just a expense line item in budgets, if not given appropriate value, inaccurate credentialing will impact all other revenue line items.
But here’s the truth: no automation, AI, or platform alone will solve the core challenges of credentialing and enrollment.
Where Epic (or any technology solution) cannot change the game:
- Payer policy shifts (e.g., Aetna & Cigna underpayment issues, Prior Auth changes, CMS Method II updates)
- Constant legislative changes that reshape enrollment requirements
- The payer-driven bottom line that dictates adaptability in the credentialing space
- Changes mandated State by State to Tele-Medicine do’s and don’ts
- No software solution is built for such degree of flexibility and adaptability
- Any regulatory change within Credentialing world would require update to the software and then push out those changes to a Live environment.
- This means your current workflows will have to be changed
- This means your team will have to be retrained
- This means you will need to reengage with project teams to develop an implementation plan
- This means you will have to reinvest some additional $$ that you may not have budgeted for
- This means you will not adopt the new changes
- This then means that you will have to work outside of the software system to be complaint with regulations
- Each healthcare system who would like to implement such an interoperable and interconnected solution will have to plan for these updates and changes
- Medicare, Medicaid and other Insurance companies will not give 2 hoots about weather EPIC or any other software solution can meet timelines.
- We all remember NCQA Standard changes about 3 years back caught the stand-alone systems off-guard and there was a huge rush to solve the problem, some did a good job and some just didn’t even attempt.
What is Credentialing outside of Software solutions
- Credentialing is a highly interconnected process:
- Payer systems (each with unique requirements and portals)
- Clinical and revenue cycle systems
- Primary source verification (PSV)
- Medicare and Medicaid systems with rules that differ in every state
Even with Epic’s size, reach, and ability to integrate, the payer enrollment bottlenecks will remain. These are not just “ops” problems they are systemic and policy-driven.
Where Epic can add value:
- Better access to OPPE and quality data
- Smoother onboarding workflows after Board approvals
- API-driven integrations that support MSPs
Epic’s entry will bring healthy competition to MDStaff, CredentialStream, Medallion, MODIO or QGenda — but it won’t be the silver bullet.
Healthcare organizations need more than integration-they need a partner who understands payer requirements, compliance risks, and operational realities. Helping you build credentialing and enrollment strategies that keep pace with regulation, reduce revenue risk, and work seamlessly with technology-Epic included.
Ready to rethink credentialing beyond software?
At Cred2Bill, that’s where we come in:
