Medical credentialing is a big and complex process. It has been carried from long before dating back to medieval period. It involves benefits, many issues and practices. However, due to its significance in the field one cannot go away from it also. In such case professionals can be a good support.
You must understand what is a medical pr physician credentialing? This credentialing is a process to examine and review the qualifications and career experiences of a health care provider. The qualifications include education, medical certification, licenses and trainings that the health provider has taken. This process needs to be completed before hiring a new doctors and it should meet the criteria and standards of organization National Commitment for Quality Assurance (NCQA).
So, you need to consider some points before hiring a Physician credentialing services. These services include different processes like:
- Credentialing:
Thus process includes thedoctors’ qualifications, education, training and skills.
- Enrollment:
This process used by different service providers to campaign for requestingenrollment. It also involves requires application submission, license submission and copies of insurance submission. After then only contract is signed.
- Privileging:
The process in which the medical professional is granted permission to perform clinical activities. Itis needed because the professional must treat the patients safely.
These processes are necessary as far as safety of patients are concerned. It also provides the ground on which the insurance company will decide which service provider meets the requirements to be enrolled.
The Medical credentialing services involves the following credentials:
- Career History
- Licensing
- Education
- Qualifications
- Certifications
- Residency
Information Required:
The information required to be furnished for the provider application are:
- Personal information
- Educational information
- Work history
- Attestations
- Current work status
- State of malpractice insurance
- Current hospital privileges
You must do a proper research before applying for the same because the requirements may vary from place to place.
Personal Information:
Information like citizenship information, date of birth, email address, ethnicity, gender, name, contact number, photo, social security number, etc. are required in this field.
Educational Information:
It involves the information like attendance month and year, degrees or certifications institutions, program director name.
Work Information:
Current CV, licenses copy, hospital affiliations, malpractice claims history, practice history, professional liability insurance, practice phone number, practice address, professional certificates, work history. These are the information required in this field.
Benefits:
- Reducing mistakes in applications.
- Saves Practice Time
- Less paperwork
- More scheduled spaced for staffs
- Reducing operational costs.
Time:
The durations that the complete process requires takes almost 90 to 150 days.
The practices to be followed in Physician Credentialing Process:
- Updating:
You must be updated with relevantorganizations which can make your work easier.
- Credentialing Packet:
To make the application process easier, you must prepare a credential packet with all the information and tools.
- Early start:
You must start the application process immediately so that you do not run out of time. Since the process is time taking so, start immediately.
