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Physician Credentialing & Onboarding Checklist - Download Your Own Guide
The credentialing process can be complex. Our checklist is full of tips to help you prepare.
The Fundamentals of Physician Credentialing
Physician credentialing is the process of gathering and verifying the professional records of a doctor that qualify them to practice medicine. These professional records typically include education, employment history, board certifications, malpractice insurance and more.
Why Is Credentialing Needed?
While physician credentialing is mandatory for doctors working in a professional medical environment, it’s also highly important for patients, healthcare providers and other medical staff.
7 Benefits of Physician Credentialing
1. Lowered Risk of Medical Errors
2. Protection From Potential Legal Disputes
3. Improved Patient Trust in Physicians
4. Greater Professional Reputation
5. Fewer Restrictions From Insurance Providers
6. Increased Cost Savings
7. Adequate Staff Levels
Credentialing is essential because it prevents the admission of unqualified physicians to hospitals, private medical practices and other healthcare facilities. It’s an important safety check that ensures doctors have the necessary education, training and licensure to care for patients.
Key Considerations for Credentialing in 2023 & Beyond
As of 2023, the healthcare credentialing market is expected to grow through at least 2030. The COVID-19 pandemic has fast-tracked technological innovations in the healthcare industry like telemedicine, which will continue to drive changes in the credentialing process.
In coming years, we can expect technological developments like artificial intelligence (AI) to change the credentialing process. Advanced AI programs equipped with machine learning capabilities can help to verify licensure information, educational records and malpractice history. This has the potential to streamline physician credentialing by reducing the need for manual verification of records and automating certain processes.
Preparing for the Credentialing Process
Before starting the credentialing process, it’s important to know the particular regulations in your state. The credentialing process can take anywhere from 90 to 150 days to complete, so it’s recommended that doctors review their physician credentialing checklist and begin the process as early as possible before starting a new job.
Submitting a Pre-Application
Depending on the healthcare facility or covering provider, physicians may be required to submit a pre-application. This is done to eliminate any unqualified or ineligible doctors from the provider credentialing process. The pre-application process functions as a background check and covers concerns such as criminal records, disciplinary actions and board certifications (or lack thereof).
Submitting an Official Application
For the official credentialing application, physicians will be required to provide professional information.
Entering the Formal Application Phase:
1. Complete Professional History
2. Educational History and Transcripts
3. Provider's License to Practice Medicine and Board Certification
4. Proof of Continual Malpractice Coverage or Professional Liability Insurance Coverage
5. Personal Health History
6. Professional References
The information provided in your application must be supported by copies of the relevant documents, letters of recommendation and a copy of your CV.
Verification of Receipt
Once you’ve submitted your application, the medical staff services office will begin to verify the information provided. At this time, it’s a good idea to follow up with a call or email to confirm receipt of your application.
Evaluation and Approval
Department heads and hospital boards will meet to evaluate your application and approve your employment. Some healthcare organizations will make employment decisions based on the medical staff services office’s approval without the need for board evaluation. This process may take weeks or longer.
Download Our Guide and Learn More
Once you’ve accepted an offer and onboarding begins, the credentialing process is the next step in verifying you for employment, staff privileges, EMR access, etc.
Avoid surprises by using this physician credentialing process checklist outlining the paperwork that’s likely to be requested by your new employer’s HR department to gather your documents.
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