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Credentialing vs. privileging

Residency Program Insider, October 12, 2018

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Editor’s Note: The following is an excerpt from The Clinician’s Quick Guide to Credentialing and Privileging. For more information about this book, click here.

Although the words credentialing and privileging are often confused or may be used interchangeably, they are different processes.

Credentialing is the process the healthcare facility or managed care organization/health plan uses to collect and verify the credentials of the applicant. This includes verification of many ele¬ments such as licensure, education, training, experience, competency, and judgment. The results of credentialing are used to support the privileging process. 

Privileging is the process by which a practitioner is granted permission by the facility to provide patient care services. Privileges are granted within an area of practice, such as cardiology, internal medicine, family medicine, etc. Privileges are not a right. The applicant must prove that he or she is qualified to have privileges through documentation of training, experience, and current competency. Privileges are also granted based on consideration of the procedures and types of care, treatment, and services that can be provided by the facility. The facility must have the necessary equipment and have trained staff to support the procedures/treatments the practitioner wishes to perform.

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