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Medical credential is a process used to evaluate the qualifications and practice history of a doctor or healthcare provider to establish competency. This process includes a review fo doctor's complete education, training, residency, and licenses. It also includes any certifications inssuedby a board in the doctor's area of specialiy. Hospitals, insurance providers, Medicare and Medicaid conduct medical credentialing to determine which physicians meet their requirements prior to permitting them to practice in their network. These entities continue to do so, on a regular basis as dictated by states, regulatory bodies and accrediting organizations. While this may seem like a simple, straight-foward process, each hospital and third-party agency requires their own specific type of medical credentialing processes, forms, rules and requirements. Therefore, it it imperative to know the specifics of each hospital or agency in order to save time, money and headaches.

Credentialing