Provider credentialing--managing the quagmire.
Credentialing of health care providers by managed care organizations has increased rapidly in recent years. Credentialing as a process is not new, especially to physicians who have for many years been credentialed by hospitals and other institutions. What is new, is going through the process with every individual third-party payor. It is also new, and sometimes mysterious, to advanced practice nurses and other nonphysican providers who are attempting to be included in provider networks for the first time. The key to an effective process is to have efficient, centralized systems in place that manage and track it, and providers and staff who understand the system.
Brooking
B
B
Vanderbilt University School of Nursing, Nashville, TN 37240, USA.
D003406:Credentialing; D017598:Efficiency, Organizational; D006282:Health Personnel / Q000592:standards*; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008329:Managed Care Programs