Resources

Healthcare organizations are under growing pressure to onboard providers faster, reduce administrative burden, and maintain compliance across increasingly fragmented systems. In this fireside chat, Nick Helfrich of CertifyOS and Mark Wankier of Select Health explore why traditional credentialing models no longer scale — and how shared approaches to provider data and credentialing can unlock meaningful operational gains.

Across healthcare, administrative burden is one of the biggest barriers to progress. Providers want to spend more time caring for patients and less time navigating paperwork. Hospital systems are under pressure to streamline workflows, control costs, and improve access and experience. Health plans, which finance much of patient care and connect providers, systems, members, and regulators, face growing operational demands of their own.

For health plans, provider data has quietly become one of the most critical—and most fragile—foundations in the enterprise. What was once treated as a compliance function now directly impacts claims accuracy, network adequacy, member experience, and financial performance. Yet many organizations are still debating provider data strategy as a simple build-versus-buy decision, even as the complexity and regulatory velocity of the space continues to accelerate.

Digital innovations over the last several decades have reshaped how healthcare is delivered, managed, and experienced. Many of us remember crowded doctors’ offices lined with manila folders, handwritten prescriptions that were hard to decipher, and nurses manually recording notes after visits.

It has become increasingly clear that the entire provider data system is at a breaking point.

In the evolving landscape of healthcare, modern technology holds incredible promise. Today, it’s driving advances in diagnostics, improving cost efficiency, and transforming administrative processes. The potential to enhance patient outcomes, reduce waste, and create a more connected, efficient healthcare system continues to grow, pointing to a future that’s smarter and more sustainable.

The healthcare industry simply cannot operate efficiently when provider information is fragmented, out-of-date, or siloed. Without appropriate Provider Data Management (PDM), health plans, systems, and patients face major failures:

Delegated credentialing is a formal process in which a health plan or payer gives a provider group, MSO, or delegated entity the authority to credential its own clinicians using NCQA-aligned standards. Instead of submitting every provider for manual review, organizations with mature credentialing operations can take on the responsibility themselves — reducing timelines, lowering administrative load, and improving network expansion. This guide breaks down what delegated credentialing is, how it works, the compliance requirements involved, and what it takes to qualify.