Definition of Provider Credentialing

Provider credentialing refers to the process of certifying physicians to be employed by doctor`s offices and medical practices. It also refers to a specialization in which a company acts in an intermediate manner to assist applying physicians with the process through collecting and maintaining necessary documents.

Steps

• The main steps to provider credentialing include the state granting the physician a license, the physician being granted hospital privileges and the physician applying for credentials.

Documentation

• Important documentation in provider credentialing includes paperwork on education, professional references and previous hospital affiliations.

Malpractice History

• Another requirement is any existing history of malpractice and/or malpractice insurance board certification.

Time Frame

• The process of credentialing can be a lengthy one with estimates of around a year to gather all the paperwork from various sources. Provider credentialing specialists quote a shorter period but acknowledge some forms are harder to obtain than others.

Provider Credentialing Services

• Those in the profession of provider credentialing claim their services reduce administrative burden and associated costs. Routinely, services include collecting, compiling and maintaining the accuracy of needed data.