The Best Way to Understand Medical Credentialing
In case the term medical credentialing is new to you, this savvy lead will explain it all, what it means and what you need to know about it. The simplest way to explain this term is, it is a process that is conducted to various healthcare providers to ensure that the set standards are met by all healthcare providers in the healthcare market for the mutual benefit of every party that is involved in the provision of medical service. Medical credentialing is a noble verification process of the healthcare provider where the regulatory bodies deal directly with the relevant primary sources to ensure that every healthcare provider is full qualified. In the whole medical credentialing process, the CVO, which is the credentialing authority, contacts the university which a healthcare provider graduated from in a degree of medicine, the places or colleges from which they go their trainings and also their residential areas or places as a way of verifying their credentials. To verify the certificates and specialty of the healthcare provider or providers, the CVO also contacts the certification boards and licensing bodies respectively.
It is also to note that medical credentialing is imperative to all new employees. But, it is also important to ensure that this process is regularly conducted even after hiring as a way of making sure that your employees as well as the facility complies with standards set by regulatory bodies like NCQA, TJC and CMS. It is also good to note that the full process of medical credentialing has two parts which are credentialing as well as privileging. The privileging part means that the healthcare provider is granted an approval to perform specific procedures as per the skills and competencies which he or she could have demonstrated. The other part is credentialing where the healthcare provider’s competency is verified according to his or her education, licensing, training and most importantly the work experience which he or she could have gained over time.
Now that you have clear understand of what medical credentialing involves, it is also good to understand why it is important. To start with, this is a legitimate process that ensures that there is good delivery of healthcare services that meet the required standards. With this rigorous medical credentialing process, the hospitals ad clinics will be certain that they can offer healthcare services that meet the set healthcare standards out there. On the other hand, insurance firms are able to keep their costs down because they deal with professional that are competent in medical practice. When it comes to the medical practitioners, medical credentialing gives them an upper hand to receive clients from various insurance firms and this makes it easy for them to increase patients number..