Economic Credentialing
Economic Credentialing
National American University
Instructor: Leslie King
May 9, 2015
Cassandra Paulsen
Page 1 Credentialing is a very important part of how providers get jobs and locate places they can practice in. You would not want to have a doctor or surgeon not be able to prove they have met and or exceeded in school and practice. There is a lot of steps that go into credentialing, it is a system of double and triple checks to make sure the information that is being provided by the provider is accurate and correct. They will perform a back ground check, by doing this they can obtain and verify training and education, current medical licensure in the state they are practicing. Verify employment history, Medicare sanction, looking into data bases to see if there were any claims against them and how they were settled. Also they will review and time gaps in employment and privileges listed on the application. This is done to insure they are not coming into the facility and claiming to be a cardiac surgeon when they are only a general surgeon. This has also been known to cut down on fraudulent physicians. Even though that does not happen unfortunately it happens more often than not. Without credentialing in place it is said that it would end up giving providers more control over staff and the facility having less control in staffing. It is simply there to be a sort of checks and balance for all licensed and some unlicensed staffing. Each hospital, surgery center and or medical facility may vary in what they require to be able to provide the practioner with privelegdes. However, they are essentially the same and achieve the same goal.
ASCREVIEW, (ASC Accreditation, Licensure & Medicare Certification) retrieved from, http://www.beckersasc.com/asc-accreditation-and-patient-safety/10-steps-to-a-thorough-physician-credentialing-process.html
Hall, Bobinski, Orentlicher, The Law of Health Care Finance and Regulations
National American University
Instructor: Leslie King
May 9, 2015
Cassandra Paulsen
Page 1 Credentialing is a very important part of how providers get jobs and locate places they can practice in. You would not want to have a doctor or surgeon not be able to prove they have met and or exceeded in school and practice. There is a lot of steps that go into credentialing, it is a system of double and triple checks to make sure the information that is being provided by the provider is accurate and correct. They will perform a back ground check, by doing this they can obtain and verify training and education, current medical licensure in the state they are practicing. Verify employment history, Medicare sanction, looking into data bases to see if there were any claims against them and how they were settled. Also they will review and time gaps in employment and privileges listed on the application. This is done to insure they are not coming into the facility and claiming to be a cardiac surgeon when they are only a general surgeon. This has also been known to cut down on fraudulent physicians. Even though that does not happen unfortunately it happens more often than not. Without credentialing in place it is said that it would end up giving providers more control over staff and the facility having less control in staffing. It is simply there to be a sort of checks and balance for all licensed and some unlicensed staffing. Each hospital, surgery center and or medical facility may vary in what they require to be able to provide the practioner with privelegdes. However, they are essentially the same and achieve the same goal.
ASCREVIEW, (ASC Accreditation, Licensure & Medicare Certification) retrieved from, http://www.beckersasc.com/asc-accreditation-and-patient-safety/10-steps-to-a-thorough-physician-credentialing-process.html
Hall, Bobinski, Orentlicher, The Law of Health Care Finance and Regulations