Credentialing vs. privileging
Residency Program Insider, October 12, 2018
Want to receive articles like this one in your inbox? Subscribe to Residency Program Insider!
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.
Want to receive articles like this one in your inbox? Subscribe to Residency Program Insider!
Related Products
-
Residency Program Alert
Residency program managers in all specialties are challenged to effectively manage their programs as accrediting agencies...
-
Residency Program Insider
Residency Program Connection is devoted to bringing residency directors and coordinators expert advice, best practice...
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Diagnostic v. screening mammogram based on referring physician’s order
- Practice the six rights of medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Q&A: Primary, principal, and secondary diagnoses
- Pneumonia with a negative chest x-ray: Clinical diagnoses, physician documentation, and coding guidelines
- What does case-mix index mean to you?
- What to include on the incident report
- Neurological checks for head injuries
- OB services: Coding inside and outside of the package
- E-mailed
-
- Coding Clinic reiterates guidelines for provider documentation
- Neurological checks for head injuries
- Know the medical gas cylinder storage requirements
- What does HIPAA say about faxing patient information?
- Q&A: Is older guidance on facility E/M billing still valid?
- Q&A: How should we code fluoroscopy for outpatient procedures?
- Q&A: Correct use of modifiers -80 and -AS
- Know guidelines and subtle differences in code descriptions for laceration repairs
- Do not use pathology measurements to report a lesion's size
- Diagnostic v. screening mammogram based on referring physician’s order
- Searched
