The Provider Credentialing Process Explained
Credentialing a new provider to validate his or her qualifications, work history, board certifications and references is critical for all healthcare organizations as well as smaller practices.
Normally, there are two separate processes to credentialing:
- Privileging approves a provider for performing a specific set of privileges or perform certain specific procedures.
- Provider enrollment is inclusion of a new provider in all of an organization’s insurance plans, ensuring that correct and full payment is received for their services.