physician credential

Effective Physician Credentialing Tips

The process of physician credentialing is an important task that a health care institution has to undertake when hiring a new doctor. It is essentially a process that entails verifying a physician’s credibility, licensure and making extensive back ground checks for any criminal and financial misgivings in the past. This preventive measure will help eliminate any potential problems that might crop up in the future because of the new doctor, thus insuring your institutions reputation, time and revenue against tarnish.

The importance of creating a quality credentialing process

Setting up a reliable physicians credentialing process is quite a challenge. However, this helps you in the long run, by enabling you to assimilate and sift through the applicants data, allowing you to have complete information about his/ her background. Maintaining all the necessary documents will make the process of timely re-credentialing easy, thus putting less stress on your staff.

Here are a few tips to make your credentialing as effective as possible:

Check for necessary information

When checking the credentials of a prospective physician hire, you should never skimp on  a thorough background check. Most applicants tend to omit important information from their application, thus resulting in outdated or outright misleading information about them. Doing a thorough check on work history, education, attestations, malpractice insurance, hospital privileges, etc will ensure that you are not faced with any surprises later on.

This thorough check can take ample time, and you should start early when credentialing. It should usually take about 90 days for a physicians credentialing report to come through, however, it is better if you have a head start, which will give you enough time to make up for any unexpected road blocks.

Adopting CAQH

The Coalition for Affordable Quality Healthcare is a standard credentialing program that is becoming increasingly popular in the industry today. Physicians who regularly update and attest their information with the CAQH make it easier for everyone involved when credentialing, as it offers a physician’s most up to date information regarding their practice and accreditations.

Adhering to state regulations

Different states have their own laws that monitors a physicians’ credentialing, including reciprocity regulations, which helps streamline credentialing by another state. LAWs pertaining to in-state credentialing ought to be adhered to if the physician has moved from one practice to another, within the same state. These stringent measures are taken to avoid any mishaps in the future.

Up to date contact info

Ensure that your credentialing department has up to date information on all your physician’s contact details. Since the credential process involves a ton of verification and associated work, being able to contact the respected physician in a timely fashion will help eliminate avoidable delays.

Your physicians should be aware of the importance of credentialing and should cooperate with the proceedings with gusto. This will only help ease the hiring process. Make sure to explicitly communicate with the prospective employee about the specific information that he ought to furnish in order for you to carry on with the credentialing process.

Why MedConverge

At MedConverge, we have a slew of resourceful and experienced staff who offer world class billing and physician credentialing services, ensuring that your administrative operation do not interfere with your practice. For more information on our services, write to us at or call us on (800) 898-0709.


  1. Ransom, R. (2015, December 16). 10 Quick Tips for Successful Provider Credentialing. Retrieved January 27, 2017, from
  2. Roberts, L. W. (2014, July 23). Five Steps to Easy Physician Credentialing. Retrieved January 27, 2017, from
  3. What is Credentialing? (2017). Retrieved January 27, 2017, from

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