The Importance of Medical Credentialing for Medical Professionals and Health Care Insurance Providers

medical credentialing

Medical credentialing is the process of objectively evaluating the competency of a medical professional through validating the medical practitioner’s current licensures, trainings, experiences, and ability to perform health-related procedures and health care services in medical facilities they are working for. The results of the evaluation are then compared withthe standards set by the Credentialing Committee or the Medical Board of Australia. The health practitioners and hospitals are then informed of the final decision after a lengthy process.

Since the medical credentialing process is exhausting and time-consuming, many health care practitioners and insurance companies have turned to medical credentialing companies like Addval Inc. Addval Inc. has over 20 years of experience dealing with all types of requirements related to medical credentialing in any state across Australia.

Their solid background and expertise have put Addval Inc. among the leading medical credentialing companies in all of Australia. Currently, they are representing a diverse range of more than 5,000 clients. Visit addvalinc.com to discover more about this extremely useful company and their range of packages that will suit any of your medical credentialing needs. Their packages include the following:

  • New Practice/Physician Package
  • Expanding Practice Package
  • Existing Practice Package
  • State Licence Package
  • Customised Credentialing Package

Importance of Medical Credentialing

If you are a health practitioner who is unsure whether to undergo the medical credentialing process, here are profound reasons why it is important to you, the health facilities you are affiliated with, including hospitals, clinics, and even health care insurance providers, but most importantly, to the patients.

It Preserves Patient Safety

Medical credentialing is the standard process that has been utilised by medical facilities and health insurance provider companies to ensure that the independent practitioners they are affiliated with are competent. This is important in enhancing the facilities’ credibility and reputation. When competency is ensured, the risk of medical malpractice and future liability from occurring is significantly reduced and patient safety is guaranteed.

Lowers the Risks of Medical Errors

Different states require different criteria in order to establish a legal claim of medical negligence. Generally, there are four things that an injured person, the claimant, can demonstrate to pursue a successful claim.

One, an injured patient must be able to prove negligence by the hospital in credentialing or granting privileges to a medical practitioner. Two, the injured patient must be able to prove that the doctor responsible was unfit or incompetent to perform the operation or medical procedure and should not have been allowed or granted privileges by the hospital. Three, it must also be proven that the medical practitioner demonstrated negligence in providing for patient care. Four, and lastly, that the injury was a result of the hospital’s negligence in credentialing.

If hospitals and other medical facilities are proven to be negligent, injured patients are given a viable legal claim, on top of the medical damage that it can inflict. By undergoing medical credentialing of their medical staff, hospitals and other medical facilities are reducing the risk of medical errors and preserve the high quality of patient care that they are obliged to provide.

It Promotes Trust

Doctors are relied upon by their patients to perform life-altering operations and decisions. So it is important for patients to be able to trust their doctors because they basically hold the life of their patients in their hands.

By ensuring that the medical practitioners undergo a medical credentialing process, the hospital or other medical facility can ensure to the patient that they can trust their medical staff. Patients trying to choose specific doctors to take care of them are looking for someone whom they can trust. The credentialing process is a stamp of authority that signifies which doctors are duly qualified to practice in their fields, are truly board-certified, and do not have a history of medical malpractice or any other unwanted medical professional circumstance.

To Ensure Updated Skills and Techniques Acquired by the Medical Professional

Most medical facilities require their doctors and health practitioners to have proven track records of recent medical practice experience. Being away from medical practice experience for, say, two years or more is detrimental in the credibility of the medical facility. Knowledge on current medical practice is an important trait that a doctor must possess because the medical field is always improving. Modern technological innovations and techniques are developed every year to facilitate more potent and quicker treatment implementations.

The medical credentialing process is utilised by medical facilities to verify that the medical practitioners affiliated with them have indeed knowledge and skills on current medical techniques and innovations. The results of the medical credentialing process are available only to hospitals and not to patients. Therefore, patients are forced to rely on hospitals to guarantee the competency of their doctors.

To Identify the Specific Specialisation

The credentialing process also confirms that a particular clinic or hospital has indeed the ability to provide medical professionals who are legally allowed to practice on a specialised medical scope. The medical field is a vast scope, and only those who have completed their specialisation can practice and perform medical procedure related to their specific scope.

It Indicatesthe Medical Practitioner’s Commitment to Professionalism

By agreeing to undergo a medical credentialing process, the medical professional is showing his or her confidence in his or her ability to perform medical procedure and provide quality health care service. It also indicates the medical practitioner’s desire to remain relevant in the modern setting of the medical field. It shows his or her professionalism and therefore deserves to be trusted by patients to provide high-quality health care.

It Confirms Competency of a Health Care Insurance Provider

The medical credentialing process is also vital for health care insurance companies because it cements their credibility and solid reputation. It symbolises their desire to for excellence because they only pair with medical practitioners who have authentic medical records, with medical educational background that have been verified from the primary sources (such as medical schools, hospitals where they devoted their residencies and fellowship trainings), with legitimate board certifications, and guaranteed strong past experiences in the medical field. This breeds trust among the health care insurance companies’ network of valued patrons.