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Credentialing: three months to 12 hours
Every doctor who joins an insurer's network has to be checked for a valid medical license and for malpractice suits. A person did it by visiting the medical board website, confirming the license record is there, reading transcripts from the doctor's school, and searching a database of who has been sued by whom. Then the person stamped the file approved.
Curative built an agent on Claude that does all of it end to end. It visits the website, verifies the license, reads the transcript, puts the results together, and stamps the approval. The department had about five or six people, and it was the first one to go to zero people.
The delay costs doctors something real. A doctor who joins a network and then waits three months before seeing any patients is stuck in paperwork that adds none of the value credentialing is supposed to add.
Why does credentialing involve primary sources?
Accreditation standards for health plans, such as those from the National Committee for Quality Assurance, call for verifying a doctor's license and training directly with the issuing source. Copies supplied by the doctor are not enough on their own. Checking with the medical board or school confirms the record is genuine and current. Those verifications also have a limited shelf life before a decision must be made.
What is the National Practitioner Data Bank?
Congress created the National Practitioner Data Bank through the Health Care Quality Improvement Act of 1986. It collects reports of malpractice payments and of adverse actions against licenses and privileges. Hospitals and health plans query it when they credential a doctor. The aim was to keep a doctor with a troubled record from simply moving to another state unnoticed.
Why does paperwork delay care access?
A doctor cannot bill an insurer's members as in network until the plan finishes its credentialing review. Many plans spread the work across committees that meet on a schedule, which adds weeks even when the file is complete. During that time the doctor's capacity sits unused, and members have fewer choices. Faster verification shortens this gap without changing what is checked.
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