What should you do if a provider has a gap in work history?

If the payer or credentialing standard requires explanation of a work-history gap, obtain an accurate explanation from the provider and document the relevant dates.

First confirm the exact gap and the payer’s documentation requirement. Then obtain the provider’s explanation, such as additional training, family leave, relocation, non-clinical work, or another legitimate reason. The explanation should be consistent with the rest of the application and should never be invented by the credentialing specialist.

• Verify the exact gap dates.
• Follow payer-specific documentation requirements.
• Obtain the explanation from the provider.
• Keep the explanation consistent with the application.

A payer identifies an eight-month employment gap. The provider confirms they were completing additional training, and the credentialing specialist documents the explanation as required.

• Ignoring required work-history gaps.
• Guessing the reason.
• Using inconsistent dates.

Show accuracy and documentation discipline rather than treating every gap as automatically negative.