Medical credentialing is the process of evaluating the qualifications and practice history of a doctor or other practitioner in the medical field. Ideally, this will give medical facilities the opportunity to find and hire skilled, reliable doctors and, in turn, provide better access to quality health care. The question is: can you really rely on the medical credentialing process?
Is this really a beneficial process for a hospital or other organization? Will this really tell them whether the practitioner is qualified to provide health care? The best way to know for sure is to analyze all the elements of the process and see exactly how it can help.
Medical credentialing includes a review of the prospective employee's education, training, residency, and licenses. It can also take into account any certifications that have been issued by a board in the doctor's specialty. All these things must be held up to established standards and closely examined to make sure everything was completed in a competent manner.
Anyone who uses medical credentialing will start by gathering general information on the background and qualifications of the medical practitioner. And that is important to note: credentialing can apply to more than just doctors. Anyone in the medical field can be held up to this kind of examination, from chiropractors to podiatrists to physical therapists.
Then, once this information has been gathered from the medical practitioners, it must be checked against reliable, objective sources, like the National Practitioner Data Bank or the American Board of Medical Specialties. This way personal opinion can be eliminated from the process.
Next, credentialing requires that contact be established with those places or practices that the professional has spent any time at in the past. This includes not only making inquiries of the hospitals, community health centers or other places they have worked, but also the state that issued their license to practice medicine. They have to be completely sure that there have not been any sanctions or other restrictions on the professional, and that they have all the necessary training documented.
Now that that is done, the review starts. Medical credentialing is more than simply verifying the doctor's grades while they were in school. It also includes how they have acted and behaved medically during their careers. This means their conduct is examined, as is their history of any malpractice, privileges being revoked, or just any history in general of what they have done over their course of work.
Medical credentialing can get complicated with every state, hospital, and insurance company espousing different rules, forms, and standards. The bureaucracy can really start to get complicated, which is why many companies that specialize in credentialing services have started to appear. It may be difficult, but organizations are learning quickly that the process will help them provide reliable, quality health care.
Is this really a beneficial process for a hospital or other organization? Will this really tell them whether the practitioner is qualified to provide health care? The best way to know for sure is to analyze all the elements of the process and see exactly how it can help.
Medical credentialing includes a review of the prospective employee's education, training, residency, and licenses. It can also take into account any certifications that have been issued by a board in the doctor's specialty. All these things must be held up to established standards and closely examined to make sure everything was completed in a competent manner.
Anyone who uses medical credentialing will start by gathering general information on the background and qualifications of the medical practitioner. And that is important to note: credentialing can apply to more than just doctors. Anyone in the medical field can be held up to this kind of examination, from chiropractors to podiatrists to physical therapists.
Then, once this information has been gathered from the medical practitioners, it must be checked against reliable, objective sources, like the National Practitioner Data Bank or the American Board of Medical Specialties. This way personal opinion can be eliminated from the process.
Next, credentialing requires that contact be established with those places or practices that the professional has spent any time at in the past. This includes not only making inquiries of the hospitals, community health centers or other places they have worked, but also the state that issued their license to practice medicine. They have to be completely sure that there have not been any sanctions or other restrictions on the professional, and that they have all the necessary training documented.
Now that that is done, the review starts. Medical credentialing is more than simply verifying the doctor's grades while they were in school. It also includes how they have acted and behaved medically during their careers. This means their conduct is examined, as is their history of any malpractice, privileges being revoked, or just any history in general of what they have done over their course of work.
Medical credentialing can get complicated with every state, hospital, and insurance company espousing different rules, forms, and standards. The bureaucracy can really start to get complicated, which is why many companies that specialize in credentialing services have started to appear. It may be difficult, but organizations are learning quickly that the process will help them provide reliable, quality health care.
About the Author:
An essential part of healthcare is knowing what your practitioners have done in the past. Medical credentialing makes this possible. This is the only way to ensure patient safety.
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