When many people can think of it as a modern healthcare concept, credentialing has been part of the medical fraternity since the middle ages. In a brief history of credentialing by ACP Hospitalist, the practice can be traced back to as early as the year 1224.

In the editorial done by Elizabeth Scoville and James S, they can be stated indicating that, “ a young physician could gather his credentials and top it up with a master letter from his or her master physician mentor. These could be examined by a committee of master physician and upon meeting the set requirements, the emperor himself issues a medical license.”

Unlike during its early years of introduction and implementation, medical credentialing is currently a mandatory requirement for all medical facilities as guided by The Office of the Inspector General (OIG). If a medical practitioner is found to be included in the List of Excluded Individuals and Entities (LEIE) by the OIG, hospitals avoid getting into any partnerships with them as that warrants heavy legal penalties.

Why is medical credentialing mandatory?

While patients can access detailed qualifications about their mechanics and lawyers, they probably know so little about their various health providers’ qualifications. Medical credentialing is, therefore, important in allowing patients to confidentially place their trust on their trusted healthcare providers; patients are assured of their medical practitioners’ merits and qualifications.

In a bid to ensure that none of their vendors, among other stakeholders, escape the spotlights of medical monitoring, hospitals are trusting third-party services providers such as Symplr.com. Such third-parties have heavily invested in technologies that provide real time standardized processes of data collection, primary source verification and committee reviews.

They save the healthcare facilities of the massive paperwork they incur, had they relied on the traditional in-house medical credentialing procedures. Once a healthcare provider secures the services of a third-party medical credentialing services provider, every vendor, among other medical practitioners have to be authorized by the third-party before gaining access to their facilities.

If a medical practitioner tries to go beyond areas which he or she is warranted access,  a warning is sounded and alarm sent to an administrator. This requires that every medical practitioner within a healthcare facility be accompanied by a badge indicating his or her privileges within a healthcare facility.

As a mandatory practice to all healthcare institutions, medical credentialing has also streamlined the decision making processes by hospitals management bodies. They are better placed at deciding whom to engage in contracts, and whom to exclude as a result of professional malpractices that can put their patients on the line.

If a medical credentialing process is provided with adequate training and support, healthcare facilities will not only abate the various litigations resulting from getting into partnerships with unscrupulous medical practitioners but also increase patients’ safety and confidentiality in their services. With outsourcing as an option, they can gain access to advanced and efficient credentialing infrastructure that streamline the monitoring processes.