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:
- You are who you are
- You trained where you said
- You worked where you said
- You are qualified as you said (Licenses and boards)
- And that through all of that time, also be made aware of any adverse actions
How do you show you are you are?
- ID
- Passport
- Birth certificate
- Naturalization papers
- Name change and Marriage certificate documents
How do you show you trained where you said?
- Diplomas
- Letters of reference
- Online AMA or FSMB profile
How do you show you worked where you said?
- Provide a list of all hospitals where you got privileges (best practice is to include a good contact name, email and phone)
- Start dates and End dates are imperative and should be in mm/yyyy format
- Provide a list of all practices and work places that employed/paid you (best practice is to include a good contact name, email and phone)
- Start dates and End dates are imperative and should be in mm/yyyy format
How do you show you are qualified as you said (Licenses and boards)?
- List of all licenses (active and inactive) with issue and expiration dates
- List of all DEA registrations and state CDS registrations
- Online AMA or FSMB profile
- Name, email and phone of at least 3 peers who:
- Work in the same specialty as you and
- Have seen your work in the last 24 months and
- Are willing to complete a form on your behalf.
How do you show that through all of that time, also be made aware of any adverse actions?
- Insurance policy (certificates of insurance)
- NPDB self-query
- Any malpractice or other court case documents
- Honesty is the best policy!!
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.
- First, acknowledge that credentialing is inevitable, both initial credentialing and renewing. By being prepared it will take little of your time and a small amount of record keeping. Not being prepared will take a lot of scrambling and pulling of hair.
- Secondly, from day one of your medical career begin your record keeping. In a later section we will address what documentation should be kept and what dates will need to be recorded. Your files can be kept in hard copy or electronically. Either way you will have all you will need for all types of credentialing, state licensure and insurance.
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!
