Why Is Physician Credentialing Beneficial?
Generally when people think of credential that physicians possess, things come to mind like licenses, educational designations, and certificates. In reality, physician credentialing is much more than that. It includes a doctor’s duties and how he accomplishes them, and also the satisfaction of his patients.
When a hospital does not ensure the credentialing of its physicians, patient injury may result, as well as difficulty in retaining a qualified staff. Personnel of the hospital may be the ones who have to deal with his problems if an unqualified doctor is somehow hired. This issue is difficult to deal with and may not be addressed before it is too late. It could also be very costly to the hospital, or result in law suits.
To get around these issues, it’s important that hospitals keep record of a physician’s credentials. This happens by way of an impartial Physician Credentialing Committee made up of other physicians.
This committee must make their decisions based on accepted laws and standards that must be accessible to the community. These include not only a doctor’s general practices, but the level of his patient care as well. The exact criteria by which they measure it, however, can vary from specialty to specialty.
Not only does Physician Credentialing increase quality of care to patients, it also enables doctors to maintain membership in insurance networks. Among these would be government organizations like Medicaid. A number of companies have implemented custom credentialing requirements that must be followed in order to be a part of them.
If a hospital does not keep track of which of these programs a doctor has completed, and they unwittingly pair a Medicaid patient with a doctor who is not qualified to accept it, they will not be reimbursed. This can cause problems for both the patient and the doctor. On the flip side, if they turn away patients from a doctor who is qualified, they can lose a lot of money.
Finally, a hospital must maintain record of a physician’s credentials for the doctor’s sake, the welfare of the patients, co-workers, and the entire hospital.
This helps avoid costly and dangerous mistakes, increases hospital morale, and enhances patient satisfaction. More importantly, it has the potential of protecting a patient’s life from an incompetent or unqualified physician.
Tags: health and fitness, healthcare credentialing, hospital privileges, JCAHO standards, joint commission standards, medical credentialing, medical peer review, medical staff credentialing, physician credentialing, physician peer review