Credentialing is a process of evaluation of doctor’s practice and qualification. It includes a thorough review of education, residency, training and licenses. All qualifications issued by the board in the field of specialty are also verified. The doctor has to go through this process before joining any hospital’s team. Credentials are reviewed on a regular basis and each state has its own standards and regulations.
The main role of credentialing is to ensure quality health care. To submit your application, you should include all information concerning your practice. Gather all your background information and be prepared that it will be checked for reliable sources, such as American Board of Medical Specialties and National Practitioner Data Bank.
If you don’t want your application to be denied, include even small details in your application. Add all states where you report an active medical license, all your schools and training programs with start and end dates, include Controlled Substance Registration to confirm that you’re authorized to prescribe drugs. Sometimes, you should also prove that you’re not banned from treating Medicaid and Medicare patients. Your personal history is also required – different disciplinary actions is a red flag for many hospitals. After receiving your application, the Credentialing Committee will decide whether or not you can participate in patient care in the facility.
Some of your general information is also required. Your name and location, gender and specialty are accepted through a document that states this information is complete and correct. If you’re going to provide your services in several specialties, they all should be listed. Patient focus, which shows if you have a patient age specialization, and languages spoken both should be in the application.
Board certifications mean that you have been awarded a certification from the American Board of Medical Specialties. The certificate represents your current experience, skills, and knowledge and ensures you can provide quality care. Many hospitals include board certification into the credentialing process and it’s worth valuing your time and effort in obtaining the Certificate.
Credential applications are usually fill able on the computer. Simply fill out all information in the fields, this will provide more easy-readable information – which reduces the amount of questions, mistakes and delays during the credentialing process. Always take a signed copy for yourself before mailing the application to the committee. However, signatures still should be handwritten.
The easiest way to submit your application is via PECOS, or Provider Enrollment, Chain and Ownership System. PECOS helps you with the application, so don’t leave blank field and supply all important information. It results in a better-filled and more accurate application and saves a lot of time and money.
You can also submit your application by mailing it to the intermediary that serves your location. To avoid delays, mail your application to the right intermediary. Credentialing isn’t a swift process and you really want to plan everything ahead, sometimes even six or nine months before sending the application. Completing the forms takes longer today than in the past due to an increase of required documents, but if you’re not going to forego all privileges, you can’t do much about it.
Premier Credentialing Solutions, LLC has the best credentialing and licensing solutions for you and your business; We proudly offer Provider Enrollment & Physician Credentialing, Medicare – Provider Enrollment & Revalidation, Medical Licensure Services, and Full-Service Credentialing For Billers / Billing Companies. Call (800) 455-4773 for a free, no-obligation consultation.
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