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Credentialing Tips

May 25, 2015 12:57PM ● By MED Magazine

By Lavonne McKee, Credentialing USA Inc. 


Credentialing is a big undertaking. Here are a few tips to make the process smoother. 

1.  Check out the Federation of State Medical Boards.  They are a primary source of verification, so if you complete a profile with them, they serve as a one stop shop to do a primary source of verification for the following:  Medical School, Medical Transcripts, Internships, Residencies and Fellowships.  This is an electronic process so it speeds up your credentialing process.  If you are a foreign graduate, you now have a state side primary source of verification.

2.  Students be sure to get a list of procedures and how many of those procedures you’ve completed, before leaving your training.  This is now a requirement to receive some credentials and privileges.

3.  Here is an order of which you need to be credentialed.

a.  DEA – National Drug License

b.  State Medical License

c.  State Controlled Drug License (if required in the state you are practicing)

d.  Malpractice Insurance

e.  Primary Hospital Privileges

f.   Medicare/Medicaid

g.  Secondary Hospital Privileges

h.  Insurance Companies

 The process is a step by step process.  You must receive one before getting the next item.  You may overlap the times by doing paperwork while one is in process.  This shortens up the credentialing process.  Be sure to keep good notes and digital copies of what you mailed each credentialing entity.  You’ll refer back to these items more than you’d hope.

4.  Keep a list of all issue dates and expiration dates.  When doing renewals they often request the date that item was issued. (example: state medical license, hospital privilege, etc.)

5.  Be sure to complete dates with mm/dd/yyyy.  Some applications may accept mm/yyyy, but not one application will accept only the year.

6.  Keep a reference list including full addresses and complete date of the following:

a.  Documentation of all gaps in times after medical school

b.  Address of the following, include dates, emails, websites, contacts, phone numbers, sponsors:

  • From High School through Undergraduate School
  • Medical School
  • American Board Specialty
  • Internship
  • Residency
  • Fellowship
  • Hospital Affiliations
  • Hospital Privileges
  • Professional Affiliations
  • Educational Affiliations
  • Employment
  • Medical Licenses
  • Malpractice Insurances
  • Military Information
  • Continuing Medical Education

c.  Malpractice Claims – if you have any malpractice claims, be sure to keep copies of the claims and the final outcome paperwork.

Keeping this documentation current will make your credentialing process go smoother and faster.

Lavonne McKee is President and Credentialing Specialist at Credentialing USA in Sioux Falls.