Credentialing For Advanced Practice Providers (APPs)

Advanced practice providers (APP) are the essential elements in healthcare-providing organizations for effective working. APPs, like nurses and physician assistants, are mainly responsible for the care of the patients in the hospital. They also help the medical practitioners during the medical procedures. They guide the doctors about the patient’s condition because they observe them the whole day. Patients also show concern about the advanced practice providers they interact with during their treatment care process. They always want qualified, well-trained, professional nurses and physician assistants around them. This also boosts their health.

Hiring professional and well-trained APPs is of great concern, and it takes great care. Therefore, credentialing of these APPs is being done to avoid the wrong recruitments. Nurses and physician assistants with the required qualifications and proper training are hired, while the others are rejected. Credentialing is a complex process with many steps, and candidates have to go through all the steps if they are willing to join the healthcare-providing institutes as advanced practice providers.

What is Credentialing?

Credentialing is verifying all the documentation and credentials like educational records, licenses, work history, peer reviews, behavior certificates, and training certificates of the candidates. It begins with the application submission step and ends with approval or denial of application. The hospitals do Credentialing or hire a credentialing service that helps them with this process.

In short, credentialing ensures that patients receive high-quality care and service at the hospital by the medical and paramedical staff. The credentialing process helps assess which candidates fit for the advanced practice providers post. Now, credentialing has become necessary by the orders of the healthcare department of the USA.

Credentialing Procedures for Nurse Practitioners

Credentialing Procedures for Nurse Practitioners

As far as credentialing is concerned for nurse practitioners, the Credentialing process is the

same as that for medical practitioners like doctors. It has many steps, which are discussed below:

1.  Meeting Eligibility Criteria

The first step is to see the eligibility criteria for being a nurse practitioner in the hospital. Candidates should see the educational, licensing, and work history criteria. If they meet the criteria and are sure they have all the mentioned documentation, they go for the next step: submitting the document.

2.  Submission of Application

Application for credentialing is a challenging and normal step. It is a rather difficult step in which you have to give much information like demographic data, educational data, work history data, and much more. Further, all the relevant and mentioned documents are attached to the application. In case of any wrong or vague information, the application can go directly for dismissal. Therefore, give a second read to the application form to check all the information is put right. You have to attach all the documents along with the application, and the candidate should check all the degrees and certifications before proceeding with the credentialing process.

3.  Receipt

Candidates must have the proof of submitted application, which can be required in any technical error or misplacing of the application. Some institutes give the paper receipt to the candidates, and some institutes notify the candidates through emails or phone calls. It is recommended to keep a record of all data till the final decision of the application.

4.  Verification of Credentials

The most crucial step in credentialing is verifying the degrees, licenses, and other important certificates and documents. This confirms the authenticity of the documentation. Verification of degrees and certificates is done by calling or “emailing institutes like medical schools, training bodies, and licensing boards. These institutes verify the data and send the final report to the hospital or credentialing service company. 

Beyond verifying original documents, credentialing helps evaluate whether a candidate is eligible and trained for the nurse practitioner job. This decides the future of nurse practitioners for the job.

5.  Credentialing Result

Once the application is verified, it goes for approval or denial. Suppose the credentialing committee thinks the candidate is fit and eligible for working in the faculty. In that case, they approve the application, contact the candidate through email or phone, and grant him to proceed with the recruitment process. In case of denial of the application, the candidate is contacted and given some reasons for the denial.

6.  Signing the Agreement

After the approval and green sign for the job, nurse practitioners are summoned to the hospital administration to sign the agreement for the job. In the agreement, nurse practitioners are guided about the terms and conditions and the privileges they will receive in the hospital. It is very important to read the instructions carefully before signing the agreement. Now, the hospitals are shifting this to a digital process in which nurse practitioners will be informed digitally to read all the terms and conditions. This will provide them with enough time to understand everything easily.

Qualification checks for Physician Assistants

The credentialing body will check the following qualification documentation for the physician assistants:

●    Educational Background

Credentialing for physician assistants begins with the checking of educational records. Candidates must have passed the physician assistant program from the verified institute. Candidates must have a master’s degree to make a career in the physician assistant job. All educational degrees will be verified by contacting the degree-granting schools and universities.

●    Training Certification 

You can only start working as a physician assistant after getting the training for this work. In the training, candidates learn all the necessary processes that will help them while treating the patients. They can only become masters of their job by having good skills. Therefore, training certificates are verified, and the candidate must have earned a good rank in the training programs because hospitals recruit physician assistants with good scores.

●    License Checking

Like the medical practitioner, a physician assistant is also granted a practicing license after completing the necessary education and training. The credentialing process verifies the practice license by contacting the state licensing board.

●    Work Experience

Work experience is needed to get the job of physician assistant. Most candidates with work experience are recommended for the job as they are more trained and qualified professionals. Previous employers are contacted to get information about the candidate. It helps to determine the clinical skills and behavior of the candidate towards his work and patients.

●    Professional Behavior

Every person receives a character certificate from the schools where he studies, the hospital where he works, and the institute where he gets training. These behavioral and character certificates help judge a person’s loyalty toward his work. Similarly, in the credentialing process, the relevant institutes verify the character and professional behavior of the person. A candidate with good professional behavior is accepted immediately.

Credentialing Guidelines for Advanced Medical Providers

Credentialing Guidelines for Advanced Medical Providers

●    Keep the Record Clea

Keeping all the records and data clear is advised before proceeding with the credentialing process. Keep copies of each documentation, like certificates, degrees, and licenses. You must have gathered all the relevant documents to keep the credentialing process smooth and easy.

●    Start Early

The credentialing process is complex and very time-consuming. So, it is better to begin the process many days before the deadline. You may need help with some information while filling out the application form. It is advised to start the application submission process early with full care. Starting one or two days before the deadline can result in putting in the wrong information or attaching the wrong credentials.

●    Seek Guidance

If it is the first time you go through the credentialing process, it is better to seek guidance or mentorship from experienced people who have gone through this process many times. It will help you to apply without any errors.

●    Stay in Touch

After the application submission, candidates must remain informed of the proceedings. They should stay in touch with the hospital to know the status of their application. In case of any objection or error, candidates must make the corrections as soon as possible.


Credentialing for advanced practice providers is verifying the credentials like educational degrees, licenses, work records, and training certificates of the candidates. This process is important to ensure that only highly skilled professionals are hired in the hospital and that high-quality care is given to the patients. This step is vital for the improvement of the healthcare system. The credentialing process for nurse practitioners begins with the application submission, and all documents are verified.

Based on the attached information of the candidate, the credentialing committee approves or rejects the application. Approved nurse practitioners can proceed with the job and make a successful career. In the credentialing process for physician assistants, their educational background, licensing record, training certifications, work record, and professional behavior are checked and verified before granting them a job. It is advised to the advanced practice providers to start the credentialing process early as it is very time-consuming, and errors can be expected with application submission. It is also necessary to stay informed and seek professional guidance about the credentialing process to avoid any error that can delay or reject the application.