Physician Credentialing Service is a cumbersome process which requires us to gather a large amount of information regarding a healthcare professional with a holistic approach to deduce the authenticity of the information prior to submitting it to the concerned parties for processing. An efficient Credentialing process will shed light on a variety of underlying items about a healthcare professional’s history.
This would aid us in revealing a pattern and help us in identifying the root cause of some disruptions like, when they provide us with inadequate expertise to perform their basic responsibilities and provide contradicting evidence which leaves us stranded when trying to correlate the authenticity of their professional competence.
Listed below are some road blocks to be vigilant while credentialing any healthcare professional.
- Questionable breaks in Work History and reluctant to provide previous employers or organizations contact information for verification.
- Failure to provide functional peer references or peer references revealing contradicting information upon establishing contact regarding the applicant.
- Failure to provide adequate quality of care to members and unprofessional conduct which led to frequent resignations & short tenures at various Healthcare Organizations.
- Failure to provide full disclosure regarding any adverse actions, pending sanctions or revocation placed on their State Licenses/Board Certifications.
- Inconceivable level of timeframe consumed to complete the obligatory trainings and corrective actions required by the state licensing body to re-claim their licensing privileges.
- Furnishing irrelevant training or proficiencies corresponding to the privileges applied which led to withdrawal of Hospital Privileges and affiliation.
- Malpractice Insurance coverage from numerous agencies with inadequate coverage amounts and multiple gaps in coverage and not disclosing pending lawsuits voluntarily.
- Remarkably high number of malpractice lawsuits, actions and judgments filed against the Healthcare professional which reveals their level of professional conduct or potential deficiency.
e-care’s Credentialing team vigilantly follows an eye for detailed approach so that a healthcare professional meets all the criteria as required by the Payer or Healthcare Organization by reviewing the items such as the individual’s license, experience, certification, education, training, affiliations, malpractice & adverse clinical occurrences and clinical judgment and bypass all the road Blocks that could result in interruption of the credentialing process.