What is Physician Healthcare Credentialing? By Lavonne McKee
H
ealthcare credentialing has evolved over the years and plays an important role in protecting and providing healthcare services today. Physician healthcare credentialing is a process where a healthcare professional proves that he/she is educated and capable of practicing his/her healthcare specialty. The credentialing process is a lengthy process. Every healthcare physician practicing in the United States will in some way be credentialed to practice. Credentialing may be done on many different levels including but not limited to the following:
♦ ◆ State medical license, residency and/or professional in every state practicing
♦ ◆ Drug dispensing licenses on both national and in some states ♦ ◆ Malpractice insurance ♦ ◆ Health insurance companies ♦ ◆ H ealthcare facilities where practicing or holding privileges ♦ ◆ Specialty committees in which participating ♦ ◆ Federation of State Medical Boards ♦ ◆ Federation Credentialing Verification Services ♦ ◆ Medicare ♦ ◆ Medicaid and others The credentialing process varies for each healthcare professional. Some of the variances are: type of professional, services provided and state where the service is provided. The best way to find the requirements for a specific state is to refer to that specific state’s medical licensing board. A link to each state medical board may be found through the American Medical Association website at: http://www.ama-assn.org/ama/pub/education-careers/ becoming-physician/medical-licensure/state-medical-boards.page. Some of the common variances include but are not limited to: state drug license, continuing medical education hours, required residency licenses, foreign medical graduate requirements and others. ■ LaVonne McKee is President and Credentialing Specialist at Credentialing USA in Sioux Falls. To read the complete article, including details and advantages of thorough credentialing processes, Log on!
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