The Role Of Credentialing Specialist And Credential Verification Services

Credentialing is a process of gathering and verifying the authenticity of the information

provided by the professionals associated with any line of profession. Credentialing becomes even more important in the fields such as engineering, medical and legal services. These services demand high quality from their professionals and any leniency or irresponsibility can lead to serious social implications.

Credentialing in the medical profession is probably the most important of all. The doctors and physicians are people who are given the entire responsibility of the well being and health of the society. The patients entrust their future and lives to the physicians and therefore physician credentialing is a must at the hospitals, physician offices and clinics and the laboratories.

In the past, the hospitals and agencies were not serious about the credentialing and consequently there were no good mechanisms and systems in place to check the credentials of the doctors or the hospital staff. This gave opportunity to the fake doctors and nurses to practice in the hospitals through fake documents and a number of cases of death of patients due to utter negligence of the doctors came to the fore. This situation brought credentialing to the center of importance in the medical profession.

The credentialing verification services checks the following things these days:

1.Verification of the education and medical training.

2.Verification of board.

3.Licenses

4.Background: Criminal records etc.

5.Claims against malpractices etc.

6.Reviews of the medical board.

The information gathered from the various sources is reviewed by the committee in charge of the credentialing and in some cases a credentialing specialist is also hired or designated. One of the most important factors that are checked is the ethical behavior of the practitioner.

Besides the hospitals, the insurance companies including the government based sponsors and agencies review the credentials of the doctor and in some cases they carry out a fresh research on the doctor.

The credentialing specialist not only saves a lot of time of the hospitals or government agencies and insurance companies but they also make the research more trustworthy and accurate through their experience and contacts. Many web based services also play a supporting role in the credentialing services.

by: deny chandra

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