2025 Provider Credentialing Guide: Avoiding AI-Driven Denials and Enrollment

Webinar Overview

Title: The Credentialing Crisis of 2025: How AI, Payer Policies, and Delays Are Reshaping Provider Enrollment

In today’s healthcare environment, credentialing has evolved from a background function into a mission-critical component of operational success. As of 2025, the credentialing process directly impacts provider reimbursements, regulatory compliance, and even practice viability.

Amid widespread restructuring, insurance companies are eliminating direct support lines, transferring credentialing responsibilities to external vendors, and introducing delays that extend well beyond established timelines. Providers are left navigating opaque denials, minimal communication, and unclear appeal routes—all while expected to continue treating patients without assurance of payment.

One of the most concerning developments is the integration of Artificial Intelligence (AI) into payer decision-making. AI tools are being used not only to audit submitted claims and provider documentation but also to assess internal “risk scores.” These scores may silently lead to credentialing delays, denials, or network removals—with no formal notice, peer review, or recourse for correction.

This comprehensive session will uncover the newest developments in credentialing and enrollment and provide attendees with actionable tactics to protect revenue and reduce exposure.

Key Topics Covered

• Prolonged credentialing timelines: Why standard 90–120 day expectations no longer apply

• Vanishing payer communication: Navigating a system with no callbacks or email responses

• Denials with no justification: Building a solid defense through documentation and appeals

• Peer review in the credentialing process: How it’s being used to delay or exclude providers

• Legal and reimbursement risks tied to submitting claims before credentialing is complete

• Coordination breakdowns between providers, payers, and third-party vendors

• Challenges with Medicare enrollment, revalidation, and managing missed deadlines

• How AI is influencing network access, payment policies, and audit targeting

Solutions & Strategies You’ll Learn

• Tools to log and track every step of the credentialing process

• Steps to escalate payer issues in a landscape with fewer live support options

• Workflow integration across billing, compliance, and credentialing for greater visibility

• Leveraging data to prevent AI-based denials or network removal

• Expanding your revenue model through credentialing services for billing firms and MSOs

Designed For:

• Credentialing professionals and department leads

• RCM teams and billing managers

• Practice administrators and operations staff

• Healthcare compliance officers and consultants

• MSO leaders and solo practitioners seeking enrollment clarity

Whether you’re onboarding new providers, responding to unexplained denials, or working to maintain network status, this session provides practical insights for navigating today’s AI-influenced credentialing world.

Learning Outcomes

By attending this webinar, you will:

• Stay informed on current credentialing issues including Medicare delays and payer trends

• Recognize how enrollment disruptions directly affect billing, payments, and audits

• Understand the growing influence of AI in credentialing approvals and exclusions

• Build strategies for overcoming stalled communication and appeal blockades

• Learn how to document efforts effectively to protect against denials

• Establish workflows that unify credentialing, compliance, and revenue cycle teams

• Explore ways to expand credentialing into a scalable business service

Focus Areas

• Credentialing & Enrollment Delays

• Denied Contracts & Lost Communication Channels

• Reimbursement Threats & Billing Complications

• Peer Review Pressures & Compliance Risks

• Artificial Intelligence in Credentialing Decisions

• Proactive Credentialing Tools & Frameworks

Why Attend

Credentialing in 2025 is no longer a back-office formality—it’s a frontline defense for your practice. Join us to uncover the latest shifts in payer behavior, explore how AI is silently reshaping provider status, and equip yourself with the tools to stay compliant, paid, and proactive.

About the Presenter

Olga Khabinskay, Director of Operations at WCH Service Bureau, Inc., brings over 23 years of expertise in healthcare credentialing and payer relations. As the architect behind CredyApp, an innovative platform designed to streamline credentialing workflows, Olga has helped countless providers navigate complex enrollment hurdles.

She is actively involved in industry associations including AMBA, AHIMA, AAPC, PAHCOM, and HCCA, and currently serves as Chair of the HBMA Payer Relations Committee and sits on the HBMA Board of Directors. With a background in healthcare management and communications, Olga is a recognized voice advocating for transparency, accountability, and innovation in credentialing practices.