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A Credentialing Checklist for New MDs and DOs

Mar 28, 2015 06:06PM ● By MED Magazine

By Lavonne McKee 


As the medical/osteopathic student comes to complete his/her training program, there is a credentialing process that must first take place before the new healthcare professional may practice.  This process includes getting a permanent state license in the state in which they are going to practice, a national controlled state substance license (if applicable), a state controlled substance registration (if applicable), credentialing with all the insurance companies in which they choose to serve as a provider or preferred provider, government medical companies such as Medicare & Medicaid, and healthcare facility privileges. 

To complete this process the newly trained healthcare professional should put a portfolio together before he/she leaves the educational facility where they have received their healthcare diploma and training certificates. 

Below is a list of items that should be placed in the Professional Healthcare Portfolio.

1.       CME – Continuing Medical Education

-         New medical graduates are not required to have any CME’s, their medical school diploma, Internship & residency are sufficient

2.       CV – Curriculum Vitae

-         Current C.V.

-         Upon arrival of your new practice an updated C.V. with new employment information and any changed or new information.

3.       DEA – Drug Enforcement Administration – Nation Controlled Substance License

-         A copy of your DEA (if applicable).

4.       State CSR – Controlled State Registration

-         A copy of your State CSR (if applicable, not all states require this).

5.       Transcripts

-         Medical School Transcript and the address where to get a primary source of verification.

-         USMLE/FLEX/ Transcripts and the address or website where to request a primary source of verification.

6.       Government ID Numbers

-         NPI number, Medicare number(s) (if applicable), Medicaid Number(s) (if applicable)

7.       Healthcare Certificates

-         Undergraduate Diploma

-         Medical Diploma

-         Internship Certificate – if applicable

-         Residency Certificate

-         Fellowship Certificate(s) – if applicable

-         Letter of Acceptance or Certificate from Specialty Board(s) and address(es) where to request verification of acceptance or completion of certification.

8.       Healthcare Malpractice Insurance

-         Malpractice Insurance Letter stating the time you were in training, if there were/were not any claims made, name of malpractice insurance, policy number, the amount covered for both individually and aggregate.

-         Any claims made while in residency

9.       Healthcare Articles, Publications, Papers

-         Storage for your healthcare articles, publications and papers

10.    Healthcare Affiliations

-         All healthcare facility affiliations

-         All healthcare organization affiliations

11.    Immunizations

-         Childhood immunizations – if you are unable to locate your childhood vaccinations, please have proof of your immunity to childhood diseases.

-         Proof of Current TB Assessment or Shot/Test

-         Current Influenza Shot

12.    Military Documents

-         Discharge Papers (if applicable)

13.    Past/Present employment

-         Past and present medical employment and addresses where to send a request for primary source of verification.

14.    Past/Present Residencies

-         Residence address(es) since medical graduation.

15.    State Healthcare License

-         All past and current state medical residency license and/or state medical license.

16.     Other

-         A letter from the internship, residency & fellowship department(s) of what procedures were completed during internship, residency & fellowships and the number of each procedure completed.  The letter needs to be on letter head where the training procedures were was completed and must be signed in ink by the training professor/doctor.

As the healthcare professional starts his or her career, it’s important to start taking continuing

  medical education (CME) classes as soon as possible.  Be sure to ask if there are CME requirements on the state level, healthcare facility level, and healthcare specialty board level.  Each of these entities – depending on the state, facility and board where licensed – will reflect how many CME’s a healthcare professional will need to maintain. 

As the healthcare professional continues throughout his career, it’s important to keep all data updated, copies of CMEs, CME summaries and all credentials legible.  When completing the credentialing application, it is required to include complete addresses, phone numbers, and email addresses.  Another requirement is to have complete dates. Keep all data with start and completion dates in the format of MM/DD/YYYY.  The more complete the credentialing application is, the faster the process will be completed and the sooner the healthcare professional will be able to practice.

LaVonne McKee is President and Credentialing Specialist at Credentialing USA Inc. - Sioux Falls, SD