Why is Credentialing Important?

January 17, 2023

Medical credentialing is one of the essential processes in healthcare organizations. It serves to regulate and streamline getting health care professionals credentials such as licenses and registrations. 

The importance of medical credentialing stems from the potential impact on patient safety and possible legal ramifications for employers, healthcare facilities, and other providers.

Credentialing and Its Importance in Healthcare Staffing

Healthcare credential management is an essential duty for hospitals and others which leads hiring or getting coverage by an insurance carrier. It might seem like credentialing is just a paperwork task and not as important as patient care, but it is an important task. It not only protects an business from possible lawsuits, it’s also a process to ensure practitioners are qualified to do the job. It’s a protection put in place to protect patients by providing qualified, high-quality health care providers.

Here are some reasons credentialing is important:

1. Credentialing Improves Patient Trust in Healthcare Providers

Credentialing involves a rigorous process of evaluating a healthcare professional’s education, training, and experience. For patients, this serves as reassurance that they are receiving proper care from an individual with adequate training. Through credentialing, patients can also ensure that their providers follow high standards set by the accrediting body. 

In the face of growing concerns regarding healthcare professionals who cut corners to boost their financial gain, patients can be reassured when a credible entity has properly credentialed their providers.

2. Credentialing Ensure Healthcare Providers and Hospitals Don't Lose Revenue

Credentialing ensures healthcare providers don't lose revenue. Hospitals might perform surgeries or other services on patients that are not adequately insured. To receive reimbursement for medical expenses, doctors and other healthcare professionals must provide insurance companies with verifications.

If healthcare professionals fail to obtain proper credentialing, insurance providers are unlikely to reimburse medical offices which bill for the professionals. The insurer can backdate reimbursement to a medical office for services offered before credentialing the professional.

Nonetheless, since the time frame is limited, the office will likely lose thousands that the insurance payer will not refund.

3. Credentialing Reduces the risk of medical Errors

Medical credentialing is vital because it increases the quality and safety of healthcare and reduces medical errors and dangers. Good healthcare relies on trust between providers, patients, payers, and manufacturers. Credentialing provides this foundation for faith by verifying the qualifications of the medical providers who provide care to patients.

4. It Enables the Practitioner Remains Fit Within the Network

Credentialing involves evaluating the professional's background and experience. Professionals are typically required to go through the process to become members of a network. But it doesn't stop there. Continually reviewing a professional's credentials within the network to confirm their suitability may require the insurance provider.

5. Credentialing Improves the Reputation of Healthcare Providers

Credentialing helps healthcare providers establish their credentials, which reflects well on their character and professionalism. These days, patients are more curious, and to the extent that they consciously research the healthcare provider or organization they intend to patronize. 

Medical credentialing will play a key role in determining a patient's choice of a healthcare provider or healthcare organization. A professional member of a reputable medical association will be more preferred than a professional who is not.

Credentialing is an essential mechanism for ensuring quality and safety in the healthcare industry and guiding patients' choice of a provider. Credentialing helps improve patient care and protects caregivers and payers from unnecessary liabilities. 

Get Started on Your Credentialing with FloatCare

Start your Credentialing process by taking the first step with FloatCare. FloatCare provides healthcare provider credentialing services to registered members. We also assist healthcare organizations in getting staff credentials verified by the right accreditor. 

Our streamlined Credentialing process is easy to use and will save valuable time. We offer a comprehensive suite of features designed to guide healthcare providers through the credentialing process. Our service will provide helpful information about the type of degree, certificate, or license a provider may have.

Sign up today to get started.

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