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What To Expect From Physician Credentialing During A Residency

by Vincent Evans

If you've recently graduated from medical school and begun your residency program, you're already well on your way to becoming a full physician. But what does the transition from resident to attending physician really entail? Besides picking up the practical knowledge and skills every doctor needs, you'll also begin the credentialing process. Although it can be time-consuming and intimidating, this is a necessary step to further your career, protect patients, and keep your employer in good standing with insurance providers.

Understanding the Credentialing Process

In the medical industry, credentialing verifies a physician is qualified to practice medicine. The related process of privileging then determines which specific jobs a physician can perform. Without these crucial ratings, insurance companies can't work with you or bill patients properly, and employers will look elsewhere. On a basic level, credentials confirm that you have received a medical license and are eligible to practice medicine in a given state. Verifying doctors prior to hiring protects patients from applicants who might otherwise lie about their qualifications.

Collecting the Necessary Documents

As you progress through your residency, the credentialing process should begin through your facility's credentialing agency. You may be asked to provide records such as a valid government ID, your medical license, proof of immunization, a clear photograph of yourself, your national provider identifier, your diploma, and other certificates picked up during your residency. Keep these documents safely organized to expedite this step.

Responding to Requests

Once you hand over all of the required documents, be prepared to respond to questions and give more information as needed. Credentialing and privileging can be an exhaustive and exhausting process, but it's crucial to facilitate it as much as possible. Work with your credentialing authority and seek clarification if you're not sure how to move forward.

Setting a Realistic Time-Table

Even in relatively simple cases, credentialing can take months to complete. You don't want to get hired as an attending physician only to find out you can't get to work. For this reason, start preparing for credentialing early in your residency and check in occasionally to ensure verification is progressing.

Staying Up-to-Date

Finally, with any luck, your career and qualifications will only continue to grow and flourish. You may periodically need to update your credentials and privileges as you advance or change facilities. Keep your paperwork on hand and organized to expedite this. And if you ever have questions or doubts about the credentialing process, don't hesitate to contact a physician enrollment company for clinician enrollment assistance.

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