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Many patients know less about their doctor’s qualifications in the healthcare era than what they see in real life. It’s easy for them to identify any other option quickly but not this one. They are sometimes vulnerable when they have any familiar relative who is a qualified healthcare professional they can trust. So here’s when Medical Credentialing comes into the picture. 

It is defined as a review process of a health provider’s qualifications, including career history, training, education, etc. Credentialing of any person is done when the provider is hired and is critical, and the information should be up to date. It is increasing demand as it allows patients to place the trust in the chosen healthcare providers confidently. A standardized process involving data collection, its primary source verification, the committee review, hospitals, and the healthcare agencies, patients are thoroughly assured of the professional’s merit & experience. Physicians needed to engage in the paperwork credentialing process’s tedious task before a health plan could help the provider or a hospital grant the affiliation. The credentialing process, which is electronically based, reduces all the paperwork and acquires positive quality. 

Credentialing system is when the licensed medical professionals’ qualifications and providers’ background and legitimacy are assessed. 

Human error can cause severe problems if proper documentation necessary to the credentialing is not done correctly. A nurse with higher experience or a retired physician with an expired license can practice. If the error happens in this process, this can have negative ramifications to patient’s safety, the survival of a physician professional & can also have a significant impact on the institution’s reputation. Hospitals and healthcare organizations have made it mandatory to check box credentialing to continue the streamlined approach. If there is no proper understanding of cost-benefit, risk mitigation, there could be a huge problem ahead. Continuous monitoring is sometimes neglected because of less time and low cost involved. The good news is that the complex and evolving reforms have now renewed importance on healthcare organizations to process healthcare credentialing solutions that can help and meet the benchmark for better quality care of patients and reduce the overall costs of treatment. 

We can conclude that, yes, the credentialing process can be challenging, and a systematic approach can be made to avoid the pitfalls that could subject healthcare organizations to civil and criminal liability. Hospitals and healthcare organizations should take a step to consult with legal counsel with good policy paperwork that can help out with procedures and to develop a plan to minimize the credentialing risks.

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