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A Step-by-Step Guide to Healthcare Credentialing

A Step-by-Step Guide to Healthcare Credentialing
Healthcare credentialing is a complex process that ensures that only qualified professionals can provide medical care. This blog post will review the key steps involved in this vital process.

Healthcare credentialing is a complex process that ensures that only qualified professionals can provide medical care. So, what exactly takes place during the credentialing process? This blog post will review the key steps involved in this vital process.

Submitting Applications

First, the healthcare professional will submit an application that has all of the information that’s relevant to the healthcare credentialing process. Such information includes training and education, as well as references, certifications, licenses, and work history.

Primary Source Verification

All of the credentials that are provided in the previous step must be verified. That’s why the second step of the healthcare credentialing process involves confirming with the issuing institutions that all of the credentials that were provided are in fact accurate.

References from Peers

It’s important for those in the healthcare credentialing process to be acknowledged by colleagues who are familiar with their professional work. That’s why peers of healthcare professionals might get contacted to confirm whether or not a person is truly ethical and capable of completing their job properly.

Review by Committee

There will be a credentialing committee that looks over all of the information that’s submitted by a healthcare professional. That information is compared to the established standards for the industry. This is done in order to determine if a healthcare worker is suitable to be in the profession.

Decision

Once the aforementioned information is reviewed, a healthcare professional will have their credentials either granted, denied, or deferred. Sometimes, these workers will need to provide extra information before a decision can be made.

Privileging

This step applies to some healthcare professionals, like physicians. During privileging, practitioners apply for specific clinical privileges that define the types of medical procedures they are qualified to perform. This ensures that each healthcare provider practices within the scope of their expertise.

Constant Monitoring

After the initial medical credentialing has happened, a medical professional will be constantly monitored on their performance. This includes checking on their continuing education and any updated licensing statuses, among other things.

Recredentialing

Usually, recredentialing is done every two or three years. During this part of the medical credentialing process, a medical professional will have their credentials re-evaluated and updated. This is done to ensure that they’re still following industry standards, and that they can still be trusted in the medical industry.

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This entry was posted on Friday, May 31st, 2024 at 8:00 am. Both comments and pings are currently closed.