What is Physician Credentialing?
Hospitals, physician offices, managed care insurance companies, and laboratories all credential physicians. Credentialing is the act of gathering information about a doctor or medical provider to ascertain their qualifications to practice medicine in their given specialty. There are several agencies that oversee the credentialing processes. The Utilization Review Accreditation Commission (URAC) is considered the leading agency that monitors the credential and qualification standards in health care. Medical providers must go through a credentialing process before they are hired by medical facilities and insurance companies. Physician credentialing, sometimes referred to as medical credentialing, will verify education, licensure, training, quality, and overall ethical standing of the provider in the medical community. The doctor’s credential process begins with the medical provider submitting information to the credentialing agency for review. Areas of focus include: Education – verify m
