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Credentialing Tips

To help ensure the completeness of your credentialing application and expedite the process, pay particular attention to the following details.

Admitting Privileges

Physicians (MD, DO, DPM) are required to have admitting privileges OR a formalized Admit Plan.  An Admit Plan must include the following:

  • Documentation of the plan for having patients who require inpatient hospitalization admitted by physicians of the same specialty, specifically naming the physician(s) with whom a formal arrangement has been made to admit on the applicant's behalf
  • Documentation verifying a formal arrangement for admissions from the physician(s) who have agreed to admit on the applicant's behalf
  • 24/7 coverage

Work History

Provide a chronological practice history since the completion of your professional graduation or training.  Be sure to account for all time, providing months and years and an explanation of what you were doing during any gaps in time.

Drug Enforcement Certification

Physicians (MD, DO, DPM), Physician Assistants, Nurse Practitioners, Certified Nurse Mid-Wives, Certified Registered Nurse Anesthetists, and Optometrists are required to have a current DEA certification at the time of credentialing.  Submit a copy of the certificate with your application.  If you prescribe under the authority of a hospital's DEA, provide a copy of the hospital's DEA.

Malpractice Claims

The credentialing application requests disclosure of any malpractice claims, regardless of the outcome or current status.  Provide details of each incident including:

  • A brief case presentation
  • Initial findings
  • Treatment
  • Other practitioners' involvement, if any
  • Patient outcome
  • Plaintiff's allegation
  • Current status or disposition, including settlement amount, if any
 
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Provider Credentialing Tips