Services Offered
Credentialing & Privileging of health care providers
Focused and ongoing professional evaluation support FPPE/OPPE
Support with achieving and maintaining Regulatory, Accreditation Compliance
Process Improvement
Interim Leadership support
On-site & Remote Consulting services
Total Credentialing Consultants made our process seamless and efficient.
John D.
Their expertise in credentialing is unmatched and highly recommended.
Sarah L.
★★★★★
★★★★★
FAQs
What is Credentialing?
Who needs to be credentialed?
Why is Credentialing important?
Healthcare professionals who need credentialing are:
Physicians: This includes specialists and general practitioners who work in private practices or seek privileges at hospitals.
Nurses: Credentialing is required for various nursing roles, such as nurse practitioners.
Other independent healthcare providers: Any other licensed professional permitted to provide care without direct supervision needs to be credentialed by their employer, the health plans or hospital organizations they join.
It ensures a health care professional has the necessary skills, training, and experience to perform the duties and tasks effectively and protects the organization.
Credentialing is the process of verifying qualifications, such as education, licenses, certifications, and work history, to confirm competency and qualifications.
Any licensed, independent healthcare professional who works in a setting that contracts with health plans or provides care in a hospital setting needs to be credentialed. This includes physicians, nurses, and other medical staff, and the process verifies their education, training, experience, and licensure.
Why credentialing is necessary?
• Patient safety: It verifies a provider's competence and identifies any potential risk factors, such as malpractice issues or disciplinary history.
• Legal and regulatory compliance: It is a legal requirement for many healthcare facilities to comply with regulations set by bodies such as the Centers for Medicare and Medicaid Services (CMS) and The Joint Commission (TJC).
• Insurance and payment: It is required for healthcare providers to be included in a health plan's network so they can be reimbursed for services rendered to that plan's members.
It ensures compliance and patient safety.
Contact
201-781-6742
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