Credentialing & Privileging

Tips for tracking expirations: practitioner licenses

Credentialing & Verification Update, March 26, 2008

Verify licenses at initial credentialing and reappointment, as well as upon expiration. Some licensing boards allow a grace period, so ensure that you check with the appropriate licensing board to determine whether it allows one.

Regardless of whether it concerns a physician or an AHP, your organization should use a standardized process. Reminder notices can go out to individuals in advance if the organization deems this necessary. Remember, maintaining current credentials is the licensee's responsibility. Sending a reminder letter is a courtesy, not a requirement.

The MSP should ensure that primary source verification has occurred prior to the actual date of license expiration. Once a license is expired, the applicant should not be allowed to practice. Check your hearing and appeals plan to determine the guidelines for implementing automatic suspensions.

Upon expiration, if the applicant has failed to renew, your organization should place him or her on automatic suspension. A suspension notice should go out to the applicant as well as the department chief and any applicable departments (surgery, pharmacy, admitting, etc.). If the individual is an AHP, you should also notify his or her sponsoring physician. Some organizations have mechanisms in place to deactivate the physician from the clinical systems to ensure that he or she is unable to admit or attend to patients.

Reinstatement should not occur until the MSP has received primary source verification. Verification that the physician has submitted the applicable fees to the board is not verification that the license has been renewed. You must have confirmation that the licensing board has renewed the license (either electronic verification or verbal verification). Your organization can then send reinstatement notices to the appropriate individuals.

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