Medical credentialing is the process of verifying the education, training, skills, and competency of a medical professional or any health care provider who is required by law to obtain a licence before being allowed to practice. While it may just be called a process, medical credentialing companies undergo labour-intensive procedures to achieve the verification process going to the primary sources of: the licences obtained; medical schools attended; medical education completed including internships, residencies, and fellowships, among many others.
In other words, the process is very demanding and could take a long time to reach completion.
The Medical Credentialing Process
Medical credentialing has been utilised by many health care facilities in Australia to determine the competency of health care providers and thus preserve the high standard of excellent medical services that these facilities aim to provide.
In order to have a clearer picture on how the credentialing process takes place, here outlined is a general flow of the procedure.
- Submission of Application
The medical professional who expresses interest in participating and meets the standards and administrative requirements set by the medical organisation (such as the Australian Medical Council)is invited to apply. The applicant will then complete a credentialing application form.
This application includes a signed release form that will grant the medical organisation access toimportant information regarding the applicant. The application is accompanied by copies of the medical professional’s current licences and registration cards.
- Initial Screening of the Application
Prior to proceeding to the next step, the application will be reviewed and determined for completeness of basic requirements. Incomplete requirements cannot proceed for screening by the Chief Medical Officer (CMO). The CMO determines whether the application warrants a preliminary interview and gives the go signal to initiate the full credentialing process.
- Site Visit and Assessment
The next step is a site visit which will be conducted as a part of the primary credential verification. The applicant is informed that a facility assessment will be taking place before the application is presented to a Credentialing Committee. The site visit includes the following:
- Assessment of the medical practitioner’s physical accessibility
- Assessment of the medical professional’s physical appearance
- Assessment of the applicant’s availability of appointments
- Auditing of the applicant’s medical record keeping process,which includes assessment of how the medical practitioner organises his or her files, how he or she documents information regarding care, how he or she uses this information, and how he or she maintains patient information confidentiality
- Assessing the applicant’s quality of care, which can be done by examining an applicant’s medical record selected at random and then comparing it with the standards of care set by the Australian Medical Council or Medical Board of Australia.
- Primary Source Verification
This step aims to verify the medical practitioner’s legal authority to practice as well as his or her relevant experience, including trainings, internships, fellowships, etc. An external agency may be used by the Medical Council to verify information from the primary source. In this case, the Medical Council will assume the responsibility of overseeing the relevant process, such as:
- Affirming the validity of the medical practitioner’s licence/s to practice
- Verifying the status of privileges that the medical professional claims to enjoy at a hospital he or she has designated as his or her primary admitting facility
- Affirming the validity of the medical professional’s certificate/s
- Verifying the applicant’s completion of education from a medical school and other healthcare related training and residency from a healthcare facility
- Affirming the validity of his or her board certification, if he or she claims to be board certified
- File Preparation for Submission to the Credentialing Committee
After the preliminary screenings, pertinent documents will be filed and consolidated in preparation for a presentation to the Credentialing Committee. This file usually includes:
- Fully accomplished credentialing application form
- Results of the site visit and medical record keeping audit
- Results of the primary source verification
- The medical professional’s work history
- All other data relevant to the credentialing process of the applicant
- Applicant’s Information Entered Into the Database
After all the pertinent data and files have been received, the applicant’s credentialing file will be entered into the Medical Council’s credentialing database. It will be readied in preparation for the presentation to the Credentialing Committee. The database is also useful in tracking the progress of the medical professional’s credentialing application.
- Final Decision
The Credentialing Committee will then decide whether the applicant is accepted or rejected. The Credentialing Committee is comprised of medical practitioners who are experts on technical knowledge and current practices of the medical field. The Credentialing Committee reviews all applications and selects those who have complied with the basic qualifications. All applicants will then be notified of the Credentialing Committee’s decision. The notification will also include an appeals process which is useful for the applications that have been rejected.
- The Re-credentialing Phase
In the event of rejection, a re-credentialing process can be initiated on a specific date that the Credentialing Committee will set. This is usually set at least two years after the first failed credentialing decision.
The Advantages of Medical Credentialing Companies
With the tremendous task that the medical credentialing process entails, it is no wonder that the medical credentialing business has grown in popularity over the past years. Medical credentialing companies like Addval Inc. bravely carry on their shoulders the Herculean task of representing medical practitioners and working for their application to ensure that the final judgement from the Credentialing Committee is positive.
Addval Inc. is an Australian business specifically formed to answer the needs of medical practitioners on everything related to medical credentialing. They have been in the medical credentialing business for over 20 years now. You can be sure that they are confident in delivering guaranteed success for any credential application in every state across Australia.
Michelle McFarlane, RN, MSN, MBA, and her team of professional, highly competent staff at Addvil Inc. have experienced all types of credentialing situations and have seen everything. This has given them the privilege to be currently working with a large number of medical practitioners amounting to more than 5,000 practitioners they represent today.
The best thing is that the company offers various credentialing packages that will suit any need. They offer packages for new practice/new physicians, packages for expanding practice, state licencing packages, and even offer a customised credentialing package that will surely answer any medical practitioner’s needs.
So, if you are looking for a medical credentialing company that will surely answer all your needs, do not hesitate to log on to addvalinc.com and discover the easier, stress-free way to undergo medical credentialing with a high guarantee of approval. A friendly and experienced professional will be more than willing to help answer all your enquiries.