How Long Does Credentialing Process Take?

One of the most asked questions in the healthcare industry is, how long does credentialing take? Now there is no specific answer to this question as the turnaround time for medical credentialing varies.

A standard credentialing process takes from 90 to 120 days based on the guidelines. In some cases, the process may be completed within 90 days and sometimes, it can take more than 120 days.

Keeping in mind, the complexities in medical credentialing, it is best to hire experts in the field. These expert credential service providers can hasten up your credentialing process to help you get started with your medical practices as soon as possible.

Before we look into the reason why credentialing takes such a long period; let’s first understand what medical or physician credentialing is?

Medical credentialing is necessary for any medical provider to start their career in the healthcare industry. Credentialing is providing a verification that a doctor must obtain to treat patients. Just like a driving license gives you the permit to legally drive; your medical credentials allow you to provide medical assistance to patients. Credentialing is required pretty much everywhere including Medicaid, Medicare, and other private health insurance companies.

You need to provide all relevant documents including medical license, insurance, and DEA among others to complete the credentialing process.

Now that you know what medical credentialing is, let’s answer the question of how long does credentialing take for np and how to speed up the process?

Steps to proceed with the physician credentialing

Steps to proceed with the physician credentialing
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Step 1: One of the most intimidating parts of medical credentialing is the application form. The total pages on the form can be anywhere between 3 to 300 pages or even longer depending on your area of specialization. There are chances that you might have to write a letter of interest just to get an application form.

Step 2: Once you get the application form, the most tedious process starts. You must be extremely careful while filling out the application form. From filling out the application form to organizing all the medical documents in a file – every step requires extra care. It is advisable to keep everything in an orderly manner so that you do not end up misplacing an important document. Keep your diploma, certificates, CMEs, and work history with you to speed up the form completion process. Be mentally prepared to answer questions related to work experience, previous job duties, certification, any malpractices during your previous work, and much more.

Step 3: Once you complete the application form, it’s time to submit your application along with all the required documents. But the work does not stop there, you must actively follow up to find out the status of your application process. Following up on your application is a good idea, even if you have been told that it will take time.

After your application has been processed and there are no errors, you are good to go.

How can you speed up the medical credentialing process?

how can you speed up the medical credentialing process
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The best way through which you can easily catalyze your medical credentialing process is to accurately fill out the application form. Make sure there are no mistakes and you have attached all the required documents. Make sure that you are using the commonly used latest version of the credentialing application. Go through each page and fill out the form.

Do not hide any malpractice report as it can get you in trouble later as the company processing your application will ask  National Practitioner Data Bank (NPDB) for any malpractice report. The NPDB provides information about the provider’s malpractice claims or license. Many providers have caused hindrance in their credentialing process by not disclosing their malpractice claims on the application. So, it’s better to fill the form as honestly as possible.

Carefully read the application form and provide your signatures where required. Also remember, to write the current date wherever needed. Similarly, go through all list of documents required by your carrier and make sure to attach a copy of each. Some documents that you will be asked to provide are a copy of your medical license(s), copy of board certification, diploma, and malpractice claim certificate.

Forgetting to sign the document where necessary is one of the major hurdles in the medical credentialing process that can slow down the process along with providing misleading or false information. The healthcare company should give proper time to the provider to fill out the credentialing application. A minimum of 120 days should be given to a new provider to complete the application form to ensure the whole application has been properly completed.

Conclusion

Medical credentialing is an important process for the practices and practitioners in order to get eligible for serving the patients to the best of their abilities. The amount of time may vary according to the field of practice and the number of applications for credentialing. However, practitioners need to be vigilant while filling out the application forms as any incomplete or wrong information can bring consequences and eventually delays the process.