What is Medical Staff Credentialing and Why is it Done

The health care industry is a family of nurses, doctors, and patients. Without these three the health care industry would be nothing but a map of empty buildings called hospitals. The core of any hospital is represented by its doctors, nurses and the patients visiting it to get treatment for various health issues. It is true to every hospital or clinic that endeavors to provide quality medical care to its patients. After all, there would be no doctors without patients and no treatment of health issues without doctors. It is, therefore, hospitals make sure to hire doctors and nurses only after varying their records and investigating their professional background. This is where the medical credentialing company comes in.

So, what is medical staff credentialing?

As the name suggests medical staff credentialing refers to the process of verifying the hospital staff’s medical credentials to ascertain their authenticity and value. This process is imperative to hire highly qualified doctors to promote excellence in medical care. In addition to this staff credentialing is also important to build a hospital’s reputation as a leading medical care center. However, hiring unqualified doctors may cause more harm to a hospital’s reputation thus affecting its revenue cycle. Therefore, hospitals prefer to outsource medical staff credentialing from prominent medical billing companies. The medical billing companies assign a medical staff credentialing specialist to assist hospitals in the administrative task of credentialing. It is the responsibility of the credentialing specialist to approve the applications of the most promising candidates.

Why is medical staff credentialing done?

The key purpose of medical staff credentialing is to verify a doctor’s credentials like a medical degree, various certificates including medical diploma, internship, residency and fellowship, medical license and National Provider Identifier number. It is also done to investigate a doctor’s working history, cross-check medical affiliations, malpractice claims and disciplinary actions (if any).
Furthermore, medical staff credentialing is also done from an ethical point of view. It is one of the best ways to establish trust between the hospital and patients. A hospital having the most experienced doctors attempts to keep an unsaid promise of treating its patients with the utmost care and attention. There is an invisible bond that stops a patient from visiting another hospital because he/she knows that he/she is getting the best medical care.