What is Medical Credentialing?

Medical credentialing is the process of verifying the qualifications of healthcare providers. The medical credentialing process requires that healthcare providers submit documentation related to their education and training, including information about all medical school course completion and degrees, completed internships and residencies, board certifications, and licensure; they must also supply a comprehensive list of malpractice insurance carriers. Credentialing is an assessment that is used to maintain the highest possible standards for quality care, ensuring provider competency for the direct benefit of patients. Healthcare providers cannot practice without current, valid credentials.

The Credentialing Timeline

The medical credentialing process consists of three main parts: verification and evaluation, review, and approval. The entire medical credentialing process can stretch over several weeks—the length of time it takes depends on the healthcare field of the provider, whether all paperwork has been completed correctly, and the response time of the verification sources. Most providers begin the credentialing process several months before they begin practicing or before their existing credentials expire; three months is usually enough time to accomplish the process, with built-in “buffers” of time for any delays. To ensure that a healthcare provider always has current, valid credentials, the medical credentialing process is repeated multiple times over the course of his or her career. 

The Importance of the Medical Credentialing Process

The medical credentialing process is extremely important for healthcare providers and for their patients; it benefits both directly and significantly. Medical credentialing ensures that healthcare providers meet the standards and rules established within the healthcare industry by organizations including the National Committee for Quality Assurance (NCQA) and The Joint Commission (TJC), both dedicated to ensuring ethical, safe, and effective patient care of the highest quality and greatest value. The process provides peace of mind to patients who know that a healthcare provider is being held to standards that require the provision of high-quality care. A lack of current, valid credentials not only puts your practice at risk of being closed and also decreases the confidence of patients in the care provided.

The medical credentialing process is labor-intensive, time-consuming, and costly; so it is advantageous to have an organization like Quick Claimers Medical Billing on your team to handle this arduous task with efficiency and effectiveness. Quick Claimers is your go-to medical coding and billing company based in El Paso, Texas. The professionals at Quick Claimers offer coding, billing, and credentialing services to help you manage your practice so you can stay focused on patient care. Quick Claimers offers medical credentialing services to guarantee that healthcare providers have current qualifications and appropriate experience to diagnose and treat their patients. If you would like more information about medical credentialing services and the other ways that Quick Claimers can help you maximize the value of your practice, your time, and your bottom line, please reach out to the competent team today. Contact Quick Claimers Medical Billing online or by phone at 915-351-6600 to assist you with all your medical coding and billing needs.


Written by: Erika Mehlhaff