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Understanding the Vital Importance of Credentialing in Healthcare


The credentialing process is essential to any healthcare business for a variety of reasons; but mainly, it ensures everyone is protected. The facility is protected against lawsuits, patients are provided with the best healthcare, and healthcare professionals can maintain their reputation. Trust is key when it comes to medical care, and credentialing makes it easy for the patient to trust their doctors and the facility at which they are being treated. If you have a medical facility or you are a healthcare professional, keep reading to understand the importance of credentialing in healthcare.

What is Medical Credentialing?

Medical credentialing is a process that verifies whether healthcare professionals have the proper education, training, qualifications, licenses, and experience. Once this information is confirmed, they are given the green light to start their career in a hospital or a clinic. If you are a healthcare provider, you should understand that this is a requirement for you to have a career in medicine. For medical facilities, it is recommended you don’t hire any medical professional without first undertaking the credential process as this is a step that will benefit everyone involved including the patients.

Establishing Trust


In healthcare, trust can save lives. Patients who trust their doctors, open up to them and give them all the details they need to help them make a diagnosis. In some cases, a patient will have to disclose private or embarrassing information, but if they aren’t sure about the healthcare professional’s credibility, they will be reluctant to share this information.

Additionally, they may not accept their doctor’s diagnosis or method of treatment and look for care elsewhere. However, when a patient trusts their healthcare professional, they will be honest with them, helping the doctor reach a diagnosis and recommend the required treatment.

Protecting the Facility from Lawsuits

It is required by law that credentials are provided on medical records, prescriptions, and other legal documents. Additionally, a healthcare provider should be credentialed to publish medical research, testify in court, or participate in any speaking engagements. Seeking credentials will ensure your staff and facility are following the law and will protect you from lawsuits.

For this reason, if you are going to hire a healthcare professional, you must ensure they go through the medical credentialing process. However, this process can be complicated and will require additional resources. To make things easier for your facility, you should familiarize yourself with the medical provider credentialing steps required to make the process less tedious and time-consuming. Once your medical staff is credentialed, you can be certain that they never had any malpractice claims and that your facility is complying with the government’s requirements and regulations.

Even if your facility faces a lawsuit, the law will take into consideration that you have complied with the governments’ requirements and are operating legally.

Reducing Medical Errors

There are thousands of medical errors that take place every year and many of them lead to fatality. This is something that can worry both patients and medical professionals alike. Medical professionals are required to find ways to improve the quality of healthcare given so patients can feel as though they are in safe hands. One of the best ways to improve the quality of healthcare is credentialing medical providers and independent practitioners.

Credentialing will guarantee that the healthcare providers you hire for your facility are competent which will reduce the risk of medical errors and improve the healthcare system. Every patient has the right to be treated by professionals who know what they are doing and won’t make mistakes that can be fatal.

Protecting Against Loss of Revenue

Every medical facility must partner up with insurance companies or government programs like Medicare. The only way healthcare professionals can be reimbursed for expenses is by verifying their credentials before the hiring process.

However, if you hire a healthcare provider before they perform their credentialing process, the insurance company may backdate the payment. That said, there is a time limit and it varies according to state. If the credentials aren’t provided, your facility will not be reimbursed and will stand to lose thousands of dollars. For this reason, it is recommended that you ask your applicants to prepare their credential documents in advance.

Improving Reputation

Nowadays, people don’t rely on billboards or ads for anything, let alone finding the right doctor. They go online and research to make sure that they find the right person to treat them. For this reason, healthcare practitioners should focus on their online image and reputation. The best way to achieve this is by obtaining medical credentials. Credentials will give the medical professionals the permission to treat all patients. This will improve your reputation, and word of mouth and positive reviews will bring you more patients.


It is the responsibility of healthcare facilities to provide patients with the best care to guarantee their safety and protect the facility’s reputation as well. Credentialing will give you the chance to protect patients and protect your organization from lawsuits, liabilities, incompetence, or breaking the law. It will also help improve healthcare practitioners’ reputations.

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