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July 9, 2020

Category: Credentialing


  • Medical providers required by law to be credentialed
  • Credentialing committees help ensure process runs smoothly

Medical science is continuously making discoveries and advances, so it is imperative for practitioners to be familiar with the latest research in medicine.

State and local laws require medical organizations to make sure providers are properly credentialed, and for a good reason: Credentialing is a process that ensures medical providers’ knowledge and skills are up-to-date.

The credentialing process feels like a hassle sometimes, but it’s worth it. If you aren’t properly credentialed, you could end up in legal trouble.

Knowing this, credentialing might seem daunting, but a credentialing committee is a great way to get organized and reduce stress.

1. Know a Credentialing Committee’s Functions

The basic purpose of the committee is to make sure your medical establishment is operating safely, within the bounds of the law. To achieve this, your team gathers and reviews all of the documents that prove your organization’s nurses’ and doctors’ education, training, experience, and how much current information they know.

As you can imagine, this procedure is lengthy and complicated, and mistakes use time and resources. Additionally, uncertified providers typically can’t practice legally. This means that certification mistakes and disorganization cost practitioners as well, not just the organization.

For these reasons, it’s especially important to put much time and thought into the organization of your committee, its members, and its methods.

2. Know Who Can Serve

Only the best can be part of your organization’s credentialing team.

There are typically at least five clinicians in a credentialing committee. These team members should be prominent medical staff and should not have any significant errors or accidents on their records.

3. Decide Your Bylaws

Bylaws are the essential rules that dictate how your committee works.

Without well thought out bylaws, you’ll likely run into costly trouble down the line. Medical organizations have been credentialing for centuries, so it’s not hard to find a template if you’re starting from scratch.

4. Locate and Interview Potential Members

Now that you know who is qualified to serve on your committee, it’s time to choose some candidates.

Before Asking If They’re Interested

  • Are your candidates well-known in their field?
  • Have they been working in that field for at least three to five years, as is often mandatory?
  • Do your colleagues recommend them?
  • Are they members of any prominent medical associations?

How to Interview Candidates

You’ll set up interview sessions as outlined in the bylaws. You should have a few key points in mind when interviewing the clinicians you chose—such as these, among others:

  • How much do they know about credentialing?
  • Will they work well with you and the team you hope to form?
  • Do they agree with the organization’s beliefs?
  • Do they have enough time and drive to be reliable members?

5. Do a Test Run

Once you decide who will serve on the committee, gather everybody and have your first meeting. This meeting should follow the procedure described in your bylaws and is a great opportunity to make sure that your team works well together.

While you want your first meeting to follow bylaws, don’t expect you’ll get too much done on that first day. This is a time for you to cover the basics.

6. Elect a Committee Chairperson

You should elect a committee chairperson in your first meeting, who will be responsible for overseeing the work your group does.

For that reason, there are some characteristics you should look for in a potential chairperson, including:

  • Seniority and skill in their field
  • Detailed, accurate knowledge of the credentialing process
  • Admiration from colleagues and subordinates alike
  • An inclination toward leadership
  • Good time management, punctuality

7. Set up a Regular Schedule

Since each member of your organization’s medical staff has to recertify at different times, it’s important that your committee team meets regularly, and often. As medical professionals, everyone on your committee is in demand, so make sure to take busy, varying schedules into account.

The laws that determine how often nurses and doctors need to recertify depend on where your practice is located, so make sure you’re up-to-date on all the legal ins and outs.

8. Avoid Common Errors

Once your credentialing committee is functional, you need to watch out for some common issues. Tendencies among your group that seem minor can grow and cause disaster before you know it. So, it’s vital to nip them in the bud.

There are two basic categories of error: information errors and decision errors.

Both of these categories are broad. An information error usually means that the committee is unaware of available information, while decision errors occur when the team knows something vital, but still doesn’t use it to make their decision.

Information errors are typically true mistakes or the fault of someone outside the committee. Decision errors are arguably more concerning, as they can be a sign of corruption.

If you put the proper effort into choosing members you know are honest, and use tools available to organize your credential team’s documents and speed up the process, you won’t have these problems.

Get Your Credential Team Organized Today

Credentialing is a key process for any medical establishment, so you need a quality credentialing team to do accurate work.

This isn’t something to take lightly: If you lack a proper credentialing committee, your organization could face serious legal problems. The good news is, you’re prepared now that you’ve read the basics of starting a great credentialing committee.

So, it’s time to put that knowledge into practice—but you don’t have to do this alone. Intiva Health provides all the organizational resources your credentialing team needs.

If you have any questions about our credentialing software or want to get started, get in touch and we’ll write back as soon as possible. In the meantime, you can browse our blog for more information about medical credentialing.

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