"If we do our jobs perfectly, nobody notices," Brianna Peoples says of healthcare provider credentialing and enrollment. "And if it breaks, everybody notices." That asymmetry is the reason so many healthcare organizations underinvest in the function until it fails, and by the time it fails, the damage has already reached patients, providers, and revenue.
Brianna leads provider credentialing and enrollment at Privia Health, an organization operating across dozens of markets with thousands of providers, each subject to different payer rules, state requirements, and accrediting bodies. On this episode of Don't Get Played, she joins host Matt Jaye to talk about why credentialing keeps getting mistaken for paperwork, and what that mistake costs.
The gap starts with how the function gets categorized. Most organizations file credentialing under administrative overhead, something that happens after a hire is made and gets forgotten about. Brianna's case is that this framing hides where the real risk sits, and how far it actually reaches into revenue, trust, and patient access.
The most common misconception Brianna hears, even from people inside healthcare, is that credentialing is just paperwork. Check the boxes, gather the licenses, push the forms through. In reality, it's the mechanism that determines whether a provider can practice at all.
"It really is like operational risk management," she says. "There's a compliance piece, there's a provider experience, there's revenue cycle, patient safety. It's all kind of rolled into one." A physician can be the best hire an organization has ever made, but if enrollment and credentialing aren't done properly, they can't see patients or bill payers, and access to care slows or stops as a result.
The downstream effects compound quickly. Delayed enrollment means delayed revenue, but it also means operational strain on the providers already carrying the patient load, a provider relocating their family only to learn they can't start on schedule, and a slow erosion of trust between clinical staff and the teams meant to support them. "People think that it's an administrative inconvenience," Brianna says, "but I think that it directly affects the ability to deliver healthcare."
What works for a small practice breaks the moment an organization scales. Brianna says that the institutional knowledge and manual workarounds that get a small team through the day become a liability once you're managing thousands of providers across dozens of markets, each with its own payer behavior, licensing rules, and contract terms.
The instinct to personally fix every problem, the instinct that made her valuable earlier in her career, doesn't scale either. "We like being the hero," she admits. "But I had to learn that standardization is not the enemy of quality. When you're scaling operations, you have to be consistent because it's critical." The goal is a repeatable process that doesn't depend on any one person catching what would otherwise fall through the cracks, rather than a string of individually heroic saves.
That view extends to how she talks about AI. She sees real value in it for document processing and administrative burden, but not as a stand-in for judgment. "It gets overpromised when people talk about fully replacing that operational judgment," she says, adding that credentialing teams "still have to have that experienced human oversight."
The single change Brianna wants senior leaders to make is a sequencing one: build credentialing into the recruitment strategy from the beginning, rather than treating it as the final administrative step after a provider is already hired.
She describes her team's role with a metaphor she returns to often: "I consider us to be a crossing guard, not a stop sign." The goal is to guide the process, flagging risk and explaining decision points before an organization commits to a timeline it can't actually hit. Too often, she says, organizations recruit aggressively without accounting for payer timelines or licensing realities, and credentialing becomes the scapegoat for delays that were predictable from day one.
The remedy isn't a single conversation. It's ongoing. "I think it's education and reeducation," she says, treating that repetition as a feature of the job rather than a failure of it. Every new hiring cycle brings people who haven't internalized the timelines yet, and repeating that education is what keeps the process from becoming a surprise.
Her framing puts credentialing back at the center of the hiring decision itself, the function an organization has to get right before a start date means anything at all.