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What is Credentialing?


Credentialing is an in-depth process needs to begin immediately after a medical facility hires a new doctor.

Credentialing (also commonly referred to as medical credentialing, physician credentialing, or provider credentialing) can be defined as the process that checks a doctors background and work history. This includes reviewing any and all licenses, certifications, trainings, residency, and past education. In other words, it checks all of a doctors credentials before they start working at any medical organization. This in-depth process needs to begin immediately after a medical facility hires a new doctor. Although it can be rather burdensome, it is necessary and should not be taken lightly. Here is a quick overview of credentialing and how it needs to be used the medical industry today!

Ensure You Are Following Regulations

Not every state requires the same when it comes to medical credentialing. For example, there are some that have reciprocity regulations. It is always a good idea to check to make sure that you are staying current with all that is being required for your facility or practice.

Don’t Put Credentialing On Hold

Medical Credential is usually rather time-consuming. For this reason, it is essential to give it the time it deserves! Several things can go wrong in a medical facility (scheduling dilemmas, revenue issues, etc.). It is not a good idea to wait until the very last minute to begin this process because you need to always account for roadblocks. It is in your best interest to being credentialing at least five months in advance of the doctor’s start date. This should give you plenty of time to ensure all the necessary boxes are checked off!

Ensure You Have All The Correct Information

If you want to reduce the chances for a delay drastically, make sure all information is recorded correctly the first time around. All too often, information is either misrecorded, outdated or merely left off altogether. For example, sometimes sections of a person’s work history are not recorded. Another example would not be listing a doctors start date, which would likely throw off processing. Cases like these will hold up the entire credentialing process so everything should be doubled-checked before being submitted.

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This entry was posted on Friday, January 26th, 2018 at 10:44 am. Both comments and pings are currently closed.