For physicians, obtaining proper physician credentialing is important for a variety of reasons: your employer will require it, and insurance companies need it to verify that services provided are from a qualified healthcare professional and stay in accordance with state and federal regulations.
But what physicians have the time to figure out what is needed? We’re here to help with a physician credentialing checklist so you know what you need to include and how the process works.
Table of Contents:
- What is Physician Credentialing?
- What is the Average Time to Credential a Physician?
- Benefits of Physician Credentialing Services
- Physician Credentialing Checklist
What is Physician Credentialing?
You’ve graduated medical school, you’ve done the work, and obtained the degree. You’ve even taken your licensure tests. You’re ready to get out there and start helping people but in order to do so, you must obtain physician credentialing. After all, you can’t build your own physician credentialing checklist if you don’t understand what it entails!
Some may not realize that physician credentialing is not just obtaining your license. There is an additional step after all that work in order to start practicing, which is the official physician credentialing process. So, what is physician credentialing and why would a physician credentialing checklist help?
Physician credentialing is the verification process for Physicians. During this process, the qualifications of a medical provider are assessed to verify that they are indeed qualified, licensed, and have completed the required education in order to practice.
Why Physician Credentialing is Required
Physician Credentialing is required to verify and approve physicians so that patients know they are receiving the highest quality care available. It also sets a standard of quality that all physicians must obtain.
The process essentially gives qualified providers the green light while prohibiting those without the proper credentials from practicing medicine. A simple physician credentialing checklist will allow verifying agencies to review and approve (or reject) a physician’s credentials.
Physician credentialing is also required by the federal government for those wishing to be a Medicare and/or Medicaid provider, as well as those wishing to work in a health center. Additionally, medical groups or major hospitals and insurance providers also require physician credentialing. There is a basic physician credentialing checklist that these organizations use to verify that a physician’s credentials are valid, clear of infractions, and authentic.
What is the Average Time to Credential a Physician?
Hopefully, by now you have an understanding of what is physician credentialing — but many often have a follow-up question, which is how long the physician credentialing process takes.
Unfortunately, this answer is not as cut and dry because several factors can impact the average time to credential a physician, like location, submission volume, etc. With that said, the credentialing process typically takes anywhere from a few weeks to a few months, with the American Medical Association citing 180 days.
Because the average time to credential a physician can take weeks or even months in some states, you may consider using physician credentialing services.
Benefits of Physician Credentialing Services
There are many benefits to using physician credentialing services, the most important benefit being that you won’t have to worry about making any errors that can prolong the already long process of physician credentialing. We know what physician credentialing is, and we can help you get your physician credentialing obtained quickly.
Why Use Physician Credentialing Services
There are a number of benefits to using physician credentialing services. Here are the top three reasons to use physician credentialing services:
1. Personalized attention to help guide you through the process
2. Expertise in knowing what is needed
3. Cuts down on the average time to credential a physician
These three benefits of using physician credentialing services are often the most appreciated by the physicians we work with to obtain physician credentialing.
Physician Credentialing Checklist
Although it is certainly possible to handle physician credentialing independently, you will at the very least want to create a physician credentialing checklist to gather the appropriate information and documents.
Additionally, you may want to engage physician credentialing services to handle your credentialing, as it often cuts down the average time to physician credentialing. Basically, there is a lot of information you will need to have available before you can pursue physician credentialing.
With that said, it is certainly possible to create a physician credentialing checklist on your own. Here are some of the basic items you will want to collect to obtain physician credentialing:
1. Gather identifying information on provider (name, other personal identifying information like social security number for background checks, provider type, etc.)
2. Obtain provider’s Curriculum Vitae (this is a more substantial resume type listing experience and completed education)
3. Diploma/transcript showing degree conferral and completion of required coursework
4. State license number
5. NPI (national provider identification for Medicaid/Medicare)
6. References (peers, etc.) and clinical reviews
7. Your insurance policy (malpractice) and any history of claims
8. Results of physical and mental exam showing the practitioner is fit to practice
With this physician credentialing checklist, you are able to move forward with the physician credentialing process or seek out physician credentialing services.
Find Local Dallas Physician Credentialing Services
Getting help from local Dallas physician credentialing services like Credence Global Solutions will give you confidence in knowing that the company is familiar with your state requirements. While we have several locations throughout the country, our location in Dallas is ready to serve local Dallas physicians with the credentialing services they need. Rest easy knowing you chose one of the top physician credentialing services in Dallas!
Credence Global Solutions: The Top Physician Credentialing Service in Dallas
If you’ve read enough and have decided you’d like us to handle the physician credentialing checklist for you, we’re ready to jump in, save you average time to physician credentialing and provide the best in physician credentialing services.
Credence Global Solutions staff includes experts in the physician credentialing process who can help you get started obtaining your credentialing today. In addition to handling credentialing for physicians, we offer several other healthcare technology solutions.
Speak with our experts to learn more about our physician credentialing!
