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The Top 5 Provider Credentialing Errors

Provider credentialing, or, specifically, medical credentialing, is the process of verifying that a provider’s qualifications are current and in good standing. Typically taking place upon hiring a new candidate and as routine practice, while the provider is employed by a healthcare organization, the process consists of confirming that the applicant’s education, work history, license, and specialty certifications, and other unique identifiers are validated. Several common credentialing errors, however, could take place. These include 1. Having outdated information on the provider’s background, 2. Internal conduct investigations left unreported upon resignation, 3. Failure to authenticate critical data, 4. Credentialing specialist is under pressure to complete the credentialing and approves the application and 5. Data entry errors due to lack of attention to detail. A best practice involves continual monitoring of providers and staff after the initial credentials validation.


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Post By Ken Shafton (965 Posts)