What is Physician Credentialing?

Physician credentialing is the process of gathering and validating a physician’s records and educational background. A credentialing entity performs the task of verifying a physician’s credentials when the physician fills an application form for the hospital or clinic. This is quite an extensive process and usually takes four to six months. However, if done efficiently or through electronic means, credentialing can be carried out at a much greater pace.

Importance of Physician Credentialing

Physician credentialing is imperative because, without it, patients cannot put their trust in doctors. It is essential to avoid any kind of deception and to sidestep putting patient’s life in danger. If the validation of a physician’s professional documents is not carried out accurately, all stakeholders bear the risk. There is a big focus towards credentialing the physician records. In the age of the internet and fast technology, it has become vital for organizations to adapt to the legal procedures to verify an individual’s competency.

How to obtain credentialing information

Credentials of a physician can directly be received and verified from the primary source. The primary source includes the medical college that granted the degree, the past organizations the physician has worked in to get experience letter, and the training centers where the physician obtained training. After primary sources, the credentials can be further verified by secondary sources such as the internet. The websites of different hospitals can be an excellent source to obtain information about the work experience of the physician. Once all data is collected, a physician credentialing entity is involved, and the professional documents are verified. The information obtained is verified through the National Practitioner Data Bank or the American Board of Medical Specialties.

Credentialing comprises of two processes:

Privileging: This process allows the physician to perform healthcare activities.

Provider Enrollment: This process enables the physician to receive their organization’s insurance plans and to get paid correctly.

Physician Credentialing Can Improve Healthcare

There are several established ways physician credentialing can improve healthcare. Some of these features are explained here:

Avoid Losing Revenues

Medical credentialing Services serve as a useful way to avoid losing revenues. The time required to assess a physician’s credentials and approve them manually can be too long. The delay would result in physician joining the institution later than when he/she applied. This would cause a loss of billions of dollars. On the contrary, if medical credentialing services are performed electronically, a lot of time can be saved, and consequently, much more revenues can be generated. Similarly, enrollment of verified physicians will develop an environment of trust between patient and healthcare provider. This trust can be positively cashed, and the profits can be spent on providing even better healthcare services to patients.

Avoiding Medical Errors

Physician credentialing services assist in evading medical errors and providing the best healthcare to the patients. Similarly, medical credentialing services provided electronically can save from human error as well. The risk of mistreating patients can be significantly reduced. When only competent and well-learned individuals are employed, the probability of getting complaints from patients can be abridged to zero.

Protection from Potential Lawsuits

There are many states which require physician credentialing by law. Without credentialing, hospitals and other healthcare institutions cannot carry out healthcare activities. Failure to do so requires strict action against the institution. Physician credentialing services can save institutions from the lawsuits and improve the reputation of the healthcare providers. The lawsuits filed against such practices can potentially destroy the long-earned reputation of hospitals or clinics.

Better Care Received By Patients

The medical credentialing services can save a lot of time consumed in validating physician’s credentials, and thus more doctors are available to take care of patient health. The extra hours saved can be utilized in examining patients more carefully and thorough and offering better treatment. Similarly, lesser time would be required to hire more physicians, and thus, more patients will receive the desired healthcare.

Savings Costs

Physician credentialing services save the cost of manually verifying the documents of the physician. Credentialing can be a very costly process since it requires an accurate verification of all the data provided by an individual. But if this procedure is outsourced and carried out effectively, it can save a large sum of money. This saved amount can be spent on other necessary amenities such as the purchase of more beds, hiring of more nurses, and the purchase of better equipment. These facilities will ensure smooth treatment of patients and will promise improved healthcare. Similarly, a higher number of patients will be treated under the same amount of funds available previously. Thus, the whole system will be enhanced.

Safeguarding the Reputation of the Hospital or Clinic

Credentialing makes the healthcare provider confident of its doctors or physicians. Verification of the education and competence of the physician enables the institution to reject the false claims and save its reputation. The good standing of the institution would result in long-term profits and would benefit all the stakeholders. An institution with a better reputation will be more careful in its treatment of the patients and will try to avoid all errors at any cost. Credentialing will thus upgrade the healthcare services provided to the patients and will improve their overall wellbeing.

A Convenient Way of Physician Credentialing

Credentialing itself is a multifaceted and time-taking process. But there are ways such as electronic credentialing and cloud-based credentialing which can make this process much easier and can reduce costs as well. Sybrid MD is one of the very few top-notch companies providing best physician credentialing services. It has been serving a large number of hospitals, clinics, and solo-practitioners. The services provided by Sybrid MD are unique as it has appointed experts to provide these services. With the help of its professional and competent employees, Sybrid MD can help you upgrade your healthcare business in all possible ways. It can provide a solution to the credentialing issues your institution has been facing for long. Sybrid MD offers unique and customized services according to the size of your hospital and clinic.