The Merits and Importance of Provider Credentialing

As published by the British Medical Journal (BMJ) in 2016, 250,000 deaths per annum were attributable to medical error, making this the third leading cause of death in the United States. In addition, roughly 3 to 10 percent of the entire federal healthcare funding is lost to fraud, waste, and abuse. These two topics are a serious threat to the sustainability of the healthcare systems, but the Federal and Individual state entitlement programs have put measures in place to protect patients while mitigating fraud, waste, and abuse, and those who are found to be guilty face fines, civil monetary penalties, and possible imprisonment. Additional guidance is offered through organizations such as The Joint Commission (TJC), Det Norske Veritas (DNV), Healthcare Facilities Accreditation Program (HFAP), and others. Enforcing compliance is the path to transparency, which ultimately is the path to risk mitigation. A best-practices approach that includes a thorough screening and continuous monitoring can help build a culture of excellence and a structure that adheres to requirements and standards.


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Post By Ken Shafton (2,372 Posts)