Learn about the Alternative Credentialing process that speeds up provider onboarding with digital tools like badges and certificates.

Alternative credentialing is a fast, mostly digital way for healthcare teams to confirm a provider’s licenses, training, and clean record without the usual months of paperwork. It relies on tools like online certificates, real-time database checks, and cloud platforms, so doctors can start treating patients and receive payment much sooner while the full traditional review continues in the background.

Undergoing the credentialing process in a traditional way is like tortoise running in a race. Therefore, you can opt for some alternative ways of physician credentialing services to end like a rabbit.

For example, you are trying to start a new job as a healthcare practitioner, but before you can even say “yes” to a patient, you’re buried under a mountain of paperwork, waiting months for insurers to say, “Okay, you’re good.” That’s traditional credentialing in healthcare. There, the alternative forms of credentialing, i.e., digital badges, online certificates, and cloud-based credentialing, come in.

Let’s discuss in detail the different types of alternative credentialing in healthcare.

Alternative Credentialing Form #1: Digital Badges and Online Certificates

Do you remember collecting badges as a kid in scouts or summer camp? Digital badges are kind of like that, but for healthcare credentials.

Digital badges are verified, online representations of a healthcare provider’s qualifications. Instead of paper certificates, providers earn digital badges that can be:

• Shared easily with employers, hospitals, and insurance companies.
• Verified instantly online, reducing the need for manual checks.
• Updated in real-time when certifications renew or new skills are added.

For example, a nurse practitioner might earn a digital badge for completing a specialty training program. This badge is stored securely online and can be shared with any healthcare organization or payer needing proof.

Digital badges cut down on paperwork, speed up verification, and make it easy for providers to showcase their skills.

 

Alternative Credentialing Form #2: Online Credentialing Portals and Self-Service Platforms

Imagine if you could manage your entire credentialing process from your phone or laptop. Don’t imagine, you can. Upload documents, check status, get reminders, all without endless phone calls or emails.

That’s exactly what online credentialing portals offer. Healthcare Providers can:

• Upload licenses, diplomas, and other documents anytime, anywhere.
• Track their application status in real-time.
• Receive automated alerts when documents are about to expire.
• Communicate securely with credentialing staff.

Hospitals and clinics benefit too. Credentialing teams get all documents in one place, organized and easy to verify.

For example, platforms like CAQH ProView offer these kinds of portals. Providers love the convenience, and administrators love the efficiency. What else do they need? Timely reimbursement. That is obvious.

 

Alternative Credentialing Form #3: Automated Primary Source Verification (PSV)

Primary Source Verification means confirming credentials directly with the source, like checking a medical license with the state board.

Traditionally, this meant phone calls, faxes, or emails. Now, automated PSV uses technology to:

• Connect directly with licensing boards and certification bodies.
• Verify credentials instantly or within hours.
• Reduce human error and speed up the whole process.

This automation means less waiting and fewer headaches for everyone involved.

 

Alternative Credentialing Form #4: Blockchain Credentialing

Blockchain might sound like something from a sci-fi movie, but it’s making waves in healthcare credentialing.

Here’s how it works:

• Provider credentials are stored in a secure, tamper-proof digital ledger.
• Once verified, credentials can be shared instantly with hospitals, payers, or employers.
• Everyone trusts the blockchain record, so repeated verification isn’t needed.
• It reduces fraud and speeds up audits.

Imagine: Your medical license, board certifications, and malpractice history all stored securely on a blockchain. When you apply to a new hospital, they just check the blockchain instead of chasing paperwork.

 

Alternative Credentialing Form #5: AI-Powered Credentialing Systems

Artificial Intelligence (AI) is like a buddy nowadays. It’s helping credentialing teams work smarter, not harder.

AI can:

• Automatically read and classify documents.
• Cross-check information against databases like CAQH.
• Flag missing or inconsistent data.
• Predict when renewals or re-credentialing will be needed.

 

Alternative Credentialing Form #6: Telehealth-Specific Credentialing Solutions

Telehealth exploded during the pandemic, and it’s here to stay. But credentialing telehealth providers can be tricky because:

• Providers may practice across multiple states.
• Licensing requirements vary by state.
• Providers need to demonstrate telehealth-specific competencies.

New credentialing solutions:

• Automatically verify multi-state licenses through compacts like the Interstate Medical Licensure Compact (IMLC).
• Track telehealth training and technology skills.
• Ensure compliance with state and federal telehealth laws.

For example, Dr. Sarah lives in Michigan and wants to offer telehealth services to patients in Ohio, Florida, and Texas. Instead of applying separately in each state, she uses the IMLC. Within a few weeks, he’s licensed in all three—and treating patients from his laptop.

As of 2025, 41 states plus D.C. and Guam are part of the IMLC for physicians. That’s a lot of doors opened with one key. No cross-country paperwork tours. Just care, delivered.

This helps providers start seeing patients virtually faster and more compliantly.

 

Alternative Credentialing Form #7: Outsourced Credentialing Services

Credentialing can be time-consuming, complex, and full of regulatory twists. That’s why many healthcare organizations choose to outsource the entire process to specialized credentialing companies.

 

What Do They (Outsourced Companies) Handle?

• Collect and verify provider documents
• Submit applications to insurance networks
• Track credentialing status and follow up
• Ensure compliance with federal and state regulations
• Manage recredentialing and renewals
• Provide real-time updates and alerts

Outsourcing your credentialing process to Credentialing.org, one of the best credentialing services providers, can help you get credentialed faster than ever. They act as bridges among hospitals, clinics, doctors, and insurance companies.

 

Benefits of Outsourcing Credentialing Services to Credentialing.org

• Saves time and internal resources
• With full compliance and accuracy
• Scales easily with provider growth
• Reduces credentialing errors

 

Traditional Credentialing Vs. Alternative Credentialing

Feature	Traditional Credentialing	Alternative Credentialing
Speed	Slow (can take 60–180 days)	Fast (days to weeks)
Process Type	Paper-based, manual	Digital, automated, or platform-driven
Flexibility	Rigid and standardized	Adaptable to remote or temporary roles
Tech Integration	Minimal use of technology	High use of tech (e.g., AI, blockchain, portals)
Cost	Often higher due to admin hours and delays	Lower
Verification Method	Manual checks (emails, calls, documents)	Instant or automated checks
Best Suited For	Full-time, in-person providers	Telehealth, freelance, multi-state practitioners
Recredentialing Frequency	Every 2–3 years (or longer)	Real-time or automated monitoring
Examples	Hospital committee reviews, insurer forms	Digital badges, interstate compacts, AI systems
Limitations	Delays, errors, compliance risks	May lack universal acceptance or regulation

 

Challenges and Limitations of Alternative Forms of Credentialing?

I don’t know, but in case of alternative credentialing sometimes the “too good to be true” belief to some extent is applied. Alternative credentialing is like upgrading from slow dial-up to lightning-fast fiber internet. Sounds great, right? But just like any new tech, it has a few bad habits along the way.

Lots of Paperwork Still Exists

Even with digital tools, there’s still a big pile of documents to handle. If the system misses something or info is outdated, the process can slow down.

Every Insurance Company is Different

Each insurance company wants different things. Alternative credentialing tries to fix this, but sometimes tech just can’t keep up. So, some manual work is still needed.

Keeping Info Up to Date is Tricky

Automation depends on correct and current information. If providers upload old or wrong documents, the system breaks down and causes delays.

Not Everyone Loves New Technology

Sometimes one prefers horses over Mercedes. Similarly, some providers and clinics like the old paper and phone call way better. Training people on new systems takes time and effort. Not everyone joins the digital train right away.

Data Security is a Big Deal

Credentialing systems store a lot of personal info. This means they must be super safe to avoid hacks or data leaks. Following laws like HIPAA is a must, and it costs money and work.

Humans Still Needed for Some Decisions

AI and automation speed things up, but they can’t replace human judgment. Some checks need people to review carefully, like complex cases or hospital privileges.

Not Everyone Has Good Internet or Tech

Small or rural clinics may not have good internet or money for fancy systems. That means some providers still have to wait longer with old methods.

 

Rules For Using Alternative Forms of Credentialing

Alternative credentialing is awesome. Faster, smarter, and ready for the future. But hold up! Regulatory bodies like CMS (Centers for Medicare & Medicaid Services), OIG (Office of Inspector General), and state boards don’t just roll out the welcome mat. They have some pretty strict rules that sometimes slow down how far alternative credentialing can go.

Primary Source Verification Is Non-Negotiable

CMS says, “Sure, speed things up — but don’t cut corners!” Every license, board certification, and diploma still need to be checked directly with the official source. So even the coolest automation can’t skip that step. No shortcuts allowed.

Re-credentialing Has a Schedule

You can’t just get credentialed once and forget about it. CMS requires re-credentialing every 2 to 5 years. Alternative systems have to make sure they can keep tracking those renewals, or else, no dice.

State Licenses Matter

If you’re practicing in multiple states, you better have valid licenses for each one. Alternative credentialing platforms must verify all those state-specific licenses.

Data Privacy and Security Are Serious Business

All that provider info floating in digital clouds? It has to be locked down tight. HIPAA and other laws require ironclad security. If your platform can’t prove it’s secure, it’s a no-go.

Self-Reported Info Isn’t Enough

Just saying “I’m certified” and uploading a PDF won’t cut it. CMS wants verified proof, from primary or trusted sources. Otherwise, insurers might refuse to pay.

Telehealth Needs a Little Extra Proof

Providers must prove they know how to deliver care virtually. That means verifying telehealth-specific training, tech skills, and legal practice locations. Alternative credentialing tech has to handle all that too.

OIG and Exclusion Lists Are a Must-Check

To keep fraud at bay, credentialing systems must check providers against OIG exclusion lists and other sanction databases.

 

FAQs

What is Credentialing by Proxy?

It’s when one hospital or clinic accepts credentials verified by another organization to speed up the hiring process, especially in telehealth.

How is credentialing different from licensing and certification?

Licensing is the government’s way of saying, “You’re allowed to practice.” Certification is proof you’ve got special skills from a professional group. Credentialing is the whole process of checking those licenses, certificates, and more to make sure everything’s legit and up to date.

How long does credentialing usually take?

Traditionally, it’s a slow crawl—60 to 180 days or more. But with alternative methods, it can be done in days or weeks. Much better, right?

What if there are gaps in a provider’s work history?

Providers usually need to explain any breaks longer than six months. Credentialing teams look at these explanations to make sure providers are reliable.

What’s a Credentialing Committee anyway?

It’s a group of people who review all the paperwork, check qualifications, and decide if a provider gets privileges or can join insurance networks.

What is Privileging?

Privileging is how hospitals decide what kinds of medical tasks a provider can do there. It’s their way of making sure the provider is qualified to handle certain procedures or admit patients safely.

What is Enrollment?

Enrollment is the process that lets a provider join an insurance company’s network so they can bill and get paid for treating patients. Without enrollment, they can’t get reimbursed.