Credentialing Corner

# Building Trust Through Effective Credentialing Practices in Healthcare

- June 28, 2023
- Posted by Kristen Edwards

28 Jun

The healthcare industry is evolving at an enormous speed with every passage of time. With this evolution, patients are more reluctant to trust the medical billing process and claim for services. Whereas trust in healthcare is one of the crucial parts of retaining patients and keeping them coming. For this and for many reasons, healthcare practitioners strive to establish trust by providing effective healthcare services. However, it can only prevail through an efficient medical credentialing management process. Today in this guide, we’ll deliver the aspects affecting patient trust, the significance of medical credentialing in healthcare, and how healthcare credentialing helps enhance patient trust.

## Understanding Credentialing Management in Healthcare

The significance of medical credentialing in the healthcare industry cannot be understated. The process aids greatly in building trust among patients and providers. Patients remain sure that their care is from a verified provider. At the same time, providers make it easier for themselves to get reimbursed for the services they render.

The process of credentialing management involves verification of the education documents, academic certification, licenses, background check, malpractice history, and any other compliance requirement made mandatory by the state or the regulatory authority for the field of medicine you wish to apply in order to deliver competent and safe care to patients.

When patients seek healthcare services, they want the assurance that the professional they have chosen for medical assistance has the necessary skills and knowledge along with the experience to deliver optimal care. With the deliverance of high-level standard care, effective credentialing practices play a crucial role in instilling trust within patients and communities towards providers and healthcare organizations.

## The Significance of Medical Credentialing in Building Patient Trust

As said, credentialing plays a crucial role in healthcare. It has a lot of benefits that help patients make informed decisions about their care. The credentialing process provides a sense of security to the patients so that they will receive the best possible care. This security plays an important role in the high-risk areas in healthcare where surgeries and procedures demand extra care and involvement of multiple professionals. With credentialing, the chances of errors and mistakes become less apparent as it helps prevent medical errs, which lead to serious health consequences.

With the right expertise and experience in the relevant field of healthcare professionals, the process of credentialing ensures that patients will receive appropriate and accurate care for the associated diagnosis with comprehensive treatment. In addition, it ensures that patients are not at high risk due to medication or treatment given and would not get exposed to medical complications and unnecessary risks.

Here are some important factors that help in building patient trust through credentialing management;

- Keeping high standards of practice

Through credentialing, it can be made sure that the standards of practicing among non-credentialed and credentialed professionals remain high. Validating the expertise of healthcare providers, helps ensure that all the hired professionals are subjected to providing the same level of competent expertise.

The quality of care will further enhance the quality of care while promoting consistency in patient care. Credentialing ensures that providers are updated with the current qualification and certifications required for the field of practice and utilize the updated knowledge of evidence-based, most effective treatment and medication.

- Helps to protect the organization’s rapport

With credentialing, healthcare organizations can protect their rapport and maintain the standards in the industry. By validating the credentials and expertise of healthcare professionals, an organization would not be held liable for any negligence or malpractice claim against their employees.

How? For instance, if a provider is found providing substandard services or healthcare standards are sabotaged, then healthcare organizations would be held liable for the act as they fall short while credentialing their employees.

This is why it is important to verify the credentials and background of a provider so the organization can protect them from potential legal liabilities, including penalties and lawsuits.

- Strengthens healthcare workforce

When providers have the necessary skills to perform the right job at the right time, it enhances the overall strength of the workforce, which leads to the successful completion of tasks timely. However, the whole process needs the right education and experience, which can only be validated with the help of credentialing. This means that credentialing will confirm if providers have the skills to diagnose and treat patients effectively.

It dons important in a way that it keeps healthcare providers on the verge of career development and advancement in their profession to prosper in the healthcare industry. Also, the process broadens the vision of retaining top talent, which becomes necessary to maintain the quality of care in the healthcare industry.

- Enhances transparency and trust

The verification process automatically helps build trust and create transparency between patients and healthcare professionals. This happens subconsciously as they are more inclined to professionals knowing that they have gone through the proper credentialing process and have the necessary skills to handle their treatment and provide quality care.

Not only with patients but credentialing also promotes transparency between healthcare organizations. Identifying organizations that provide credentialed practitioners for patient care segregates from other organizations and increases credibility in the industry.

- Maintains compliance

Credentialing ensures that providers’ qualifications and expertise comply with the state-required prerequisites. Compliance is also necessary to meet the regulatory standards for the field you wish to work in.

When providers or healthcare organizations meet all the required standards of care set by the authorities, it helps avoid any unnecessary burden of legal liability and fines associated with non-compliance.

By undergoing a complete and comprehensive credentialing process, not only organizations but providers can evidently demonstrate their commitment to the provision of quality care and the safety of patients. Patients of almost every era are more likely to trust healthcare providers who have undergone rigorous scrutiny processes and have met the necessary requirements to practice in their respective medical fields.

Consequently, those healthcare organizations that keep the credentialing process as their priority get in a better position to outrank their competitors and attract patients seeking reputable and reliable care.

## Credentialing Practices for Optimal Care Provision

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In order to have an impeccable reputation among healthcare industry specialists, adopting an effective credentialing management process can leverage achieving higher results. Here are some strategies that can be adopted for medical credentialing best practices;

- Efficient verification process

When the verification process is streamlined, it automatically expedites the credentialing process, where the quality of care is rarely compromised. With the help of technology and relevant software utilization, the verification of licenses, academic documents, and certification can be made possible, reducing the burden of manual verification while maintaining accuracy.

- Re-credentialing and regular monitoring

Credentialing is definitely not a one-time process. To maintain the trust and confidence of the community, regular monitoring and re-credentialing must be implemented by healthcare organizations. This includes the evaluation of healthcare professionals periodically to ensure that they meet the established standards and are updated with the advancements in their field.

- Collaboration with the regulatory bodies

Collaborating with regulatory bodies and credentialing companies will greatly enhance your work ethic, trustworthiness, and credibility in the healthcare community. Developing interest in accreditation shows the commitment to providing continuous quality care and the pursuit of best practices in healthcare.

Patients put more effort into seeking hospitals and healthcare organizations based on their accreditation. Therefore, it becomes a defining factor for hospitals to attract potential customers and – outrank competitors.

## Benefits of Effective Medical Credentialing – The Ripple Effect

Other than providing trust to patients, credentialing repels multiple benefits to patients and the healthcare industry. Let’s dive into learning about them deeply.

- Improved patient safety

By thoroughly inspecting healthcare professionals, organizations can minimize the chances of errors. Thus, the chances of potential customer loss can be minimized. Effective credentialing process contributes to protecting patients from harm, reducing adverse events, and promoting efficient care.

- Enhanced market position

Another notable benefit of credentialing is that it sets the bar for credentialed organizations. This is because patients prioritize trust and quality care delivery while making healthcare decisions. This way, outranking other credentialing or healthcare service providers becomes easier, and by implementing robust credentialing practices, achieving desirable results would become more achievable.

- Reduced financial and legal risks

For healthcare organizations and medical professionals, it is necessary to avoid legal issues that often come after malpractice. To safeguard the financial liabilities of employees, healthcare organizations perform a credentialing process that reduces the possibility of regulatory penalties and protects the reputation.

## How can you Organize your Credentialing Documents?

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You can organize your credentialing documents by just following these simple steps;

- Create a dedicated folder for your credentialing in your system;

Whether you are maintaining a backup of document scans in your system or filing them in a file folder, keep them organized in one place, this will help get all the documents when needed.

- Divide your documents into subfolders;

To increase the search efficiency of your documents, divide your documents into categories like certification, educational, training, references, etc., so you can find any document when needed.

- Divide documents chronologically

Arrange your documents, starting from the most recent ones. This will further help in maintaining the progression of your status in the field.

- Maintain a record log

Maintain a record log in an Excel file while mentioning their locations, time of issuance, year, source, reference, and anything that is associated with it.

### Conclusion

Developing trust among patients and providers is imperative and must be one of the strongest factors of any medical organization. By prioritizing regular monitoring, streamlining the verification process, maintaining transparent communication, and collaborating with accrediting bodies, healthcare organizations and even private medical facilities can foster a culture of excellence. With the application of these strategic solutions, credentialing would leverage benefits for providers’ and patients’ safety.

### Frequently Asked Questions

- What is medical credentialing?

Medical credentialing is the process of verifying the credentials of healthcare professionals. It includes licenses, medical certification, collaborations, malpractice history, academic information, and training with experience. The process is performed to check if a provider meets the required standard of care and is eligible to deliver competent services.

- Why medical credentialing is important?

To gain patient trust, it is important to provide patients with standard care and high-quality service that can only be made possible when the provider dealing with them has the necessary skills and experience. Once patients have confidence in the services of a healthcare facility or in the provider, they can be retained. The expertise of a practitioner can only be verified through credentialing, which enhances overall satisfaction.

- Who performs medical credentialing?

Healthcare professionals, clinics, hospitals, and healthcare facilities perform the process of medical credentialing. They have a dedicated credentialing department that performs credentialing for providers and organizations. They assess and verify the qualifications and licenses before giving those credentials to work or privileges to practice for the organization they want.

- What information is verified while performing credentialing?

Depending on the field of medicine you are applying to, credentialing can be different. But generally, the credentialing process involves verifying licenses, malpractice claim history, work history, training and certification, peer references, and disciplinary actions. The credentialing process provides healthcare providers with the necessary criteria for safe, effective, and competent care.

- How long does the credentialing process take?

The duration of the credentialing process may vary depending on several factors, including the complexity of the healthcare professional’s background, the list of documents required for the verification, and the responsiveness of the external resources associated with the verification of documents (licensing boards and educational institutions). Generally, the process of verification can take weeks and months easily to complete.

Also, if the credentialing application gets rejected, the provider needs to bear the cost of credentialing again after satisfying the reason for declined credentialing.

- Is credentialing a one-time process?

Credentialing is an ongoing process that needs constant evaluation and ongoing practice. This is to ensure that every provider has the updated skills and maintains the required standard of care. Regular monitoring, staying ahead with the upgraded achievement, and re-credentialing is essential to provide quality care and maintain patient trust.

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