Credentialing (or medical credentialing or “provider credentialing”) is the process of establishing the qualifications of licensed professionals, organizational members or organizations, and assessing their background and legitimacy. Many health care institutions and provider networks conduct their own credentialing, generally through a credentialing specialist or electronic service, with review by a medical staff or credentialing committee. It may include granting and reviewing specific clinical privileges, and medical or allied health staff membership.
Why is Credentialing Important?
Credentialing plays a vital role in members’ access to quality health care.
For more information, please contact:
Anita Dumm – Credentialing Team Leader