Scroll to read more

Hiring the right staff for your healthcare practice can improve patient care and minimize the risk of lawsuits due to malpractice. Provider credentialing is a safety check that requires healthcare professionals to show their qualifications before they’re included as in-network providers. Outsourcing this service to credentialing companies can simplify your work.

What Is Provider Credentialing?

Provider credentialing is the process of verifying and assessing the credentials of healthcare experts to determine if they meet the requirements to provide effective and safe care to patients. A credentialing verification organization (CVO) can collect information to help you recruit the right talent for your healthcare practice. When staff is properly credentialed, your practice’s reputation may improve, and you may have more patient visits. Your practice can also participate in insurance networks when you have the right credentials. 

The process starts with healthcare professionals completing an application form and providing supporting documents. A CVO verifies and reviews the information to determine if they meet the industry standards. After that, the organization approves if the details are valid and in good standing.

The credentialing process involves reviewing the following details:

Educational Background

This process entails verifying a professional’s educational background, including transcripts, diplomas, and degrees from educational institutions. A credentialing company requests these details from specific institutions. They then review and verify the information. The organization establishes that the training and education the healthcare provider received are accredited and recognized by the specific accrediting bodies.

Work Experience

The staff you intend to employ should have the right skills and experience to offer safe and reliable care to patients. You can outsource credentialing to experts who can ascertain the applicants’ work experience. The company can verify the provider’s work history to see if they are a good fit for your healthcare practice. Information that’s checked and substantiated includes job descriptions, job titles, and employment dates.

Professional Certifications and Licenses

With the proper licensing and certification, staff can provide quality care to patients and will follow the code of ethics in healthcare. The provider credentialing process can determine if the licenses and certifications are valid. Verifying staff licenses and certifications before recruiting them boosts compliance with accrediting bodies. A CVO uses primary source verification by contacting licensing boards or certifying organizations to confirm the details. These companies also offer ongoing monitoring of licenses and certifications to see if they’re in good standing.

Malpractice History

Before hiring staff, you can check their malpractice history as a risk management strategy. Outsource this responsibility to credentialing professionals who can assess the severity of the claims and disciplinary actions taken against the healthcare experts. Credentialing companies also check the court documents and settlements to determine the nature and outcome of the claims. By knowing your staff’s malpractice history, you can decide whether to hire them or not based on the legal or financial consequences you may face.

Background Checks and Drug Screenings

Background checks and drug screenings for healthcare specialists can help protect patients from potential risks. This process can also help your healthcare practice stand out as a reliable and credible partner for insurance carriers. Credentialing companies conduct reference checks by contacting supervisors and colleagues listed by the healthcare specialist. They can also search local or national records and check court records to determine any criminal activity.

What Are the Benefits of Credentialing for Recruitment?

Hiring the right talent for your healthcare practice requires significant time and resources. When you outsource this service to other experts, you can save the time spent verifying the credentials and qualifications of job applicants. Use the extra time to interview and select reliable candidates.

Healthcare practices can earn money through proper credentialing. When your healthcare specialists are credentialed, insurance companies may reimburse you for the services rendered through payor contracts. When you verify staff qualifications, expertise, and licenses, you can reduce the risks of liability and hefty fines. You can prove that you validated your providers’ credentials and renewed the verification. 

Invest in Reliable Provider Credentialing Services

Credentialing helps you hire qualified staff who can serve patients effectively. Credentialing organizations can use different methods like primary source verification, direct verification, and online verification to validate details during staff recruitment. These companies can also help staff prepare documentation, complete applications, and navigate state regulations. Invest in quality credentialing services to get the right professionals for your practice.