The Credentialing and Privileging Process

In order for a physician to be permitted to practice, they must first complete the credentialing and privileging process. This verifies and assesses that a practitioner’s qualifications and license status are in good standing, and authorizes a licensed or certified healthcare practitioner’s specific scope of patient care services, and evaluates an individual’s clinical qualifications and/or performance. Telehealth providers are still required by law to undergo credentialing, but the process can be completed by proxy, allowing hospitals to avoid the full administrative burden associated with the traditional credentialing process. Things to watch out for including vague or no reference response; voluntary or involuntary relinquishment of licensure; unexplained or inconsistent time gaps or periods of time that are unaccounted for or do not match the timeline reported by organizations with which the application was affiliated; frequent employment change; numerous lawsuit; prior disciplinary action by any other healthcare organization or licensing body; and failure to disclose information.


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Post By Ken Shafton (2,363 Posts)