Credentialing 101

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Now that you have the job, the next step will be the Credentialing Process. If you have been through it you know what to expect. If you haven’t been through it, it will be an eye opener!

There is a trick to it and we are going to tell you what it is. 

The Mystery of Credentialing

If you have not yet been through “credentialing” either at a hospital, a managed care company, a clinic, for state licensure, for insurance, etc… you have probably been warned about the process. It can be daunting! 

Why do you have to credential

In hiring a physician, hospitals must comply with numerous oversight boards – the Joint Commission, CMS, state medical boards; numerous legal requirements on local, state and federal levels; in addition to adhering to their own board and bylaws.

But the basics remain the same. Hospitals must verify DIRECTLY (what they call “primary source verification”) that:

How do you show you are you are?

How do you show you trained where you said?

How do you show you worked where you said?

How do you show you are qualified as you said (Licenses and boards)?

How do you show that through all of that time, also be made aware of any adverse actions?

Be Prepared

Everywhere you will ever work in your entire medical career will require some form of credentialing. Therefore, to be prepared, and to stay prepared, we are offering a few suggestions that will take the mystery away.

Being prepared with all of this documentation and records will make your life so much easier in the future. We speak from experience!

Painful But Important

Few of us really like to keep records. Just thinking of income taxes and we shudder. Sort of like working out, getting into the habit of doing it makes all the difference. 

We point these facts out in an effort to stress the importance of keeping documentation, dates, insurance coverage, and/or malpractice suits that might occur. After you have been in practice for a few years and been through several credentialing processes you will understand and appreciate our efforts to make life a little easier for you. 

Painful? Yes, it can be. Impossible? No! Start out prepared and stay prepared, credentialing personnel everywhere will love you! 

Stay Organized

HOWEVER, there can be a light at the end of the tunnel. And that is preparation.

Having all the required paperwork available, your dates in chronological order, address and phone numbers of facilities where you have worked and/or companies you may have worked all in order……life is good! 

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