Red flags in the credentialing process

When I think of a process, I think of clear steps that one follows to consistently achieve the same end result. Whether it’s the Blog-Red-Flag1process for making cookies, mailing a package, or boarding a plan, there is a series of events that are followed and at the end we reach the same result each time.  For credentialing,  however, the  process is not as clear cut. There are many nuances and details, not to mention changes in healthcare policies that can make even the most diligent healthcare management professional have a slipup. But, unlike resulting in a soggy or over-crunchy batch of cookies, a slip-up in credentialing is far more serious.

While this isn’t fully encompassing, there are some “red flags” of the physician credentialing process that can be invaluable to know and keep an eye out for.

Certain indicators that can raise concern include:

  • Gaps in time between residencies, employment or training that are not explained or verified
  • Mismatched or missing information between the application and CV
  • Professional references that are vague, missing needed information or in any way negative

While these indicators do not account for all red flags that should be investigated prior to making a recommendation regarding appointment or clinical privileges, they are certainly some of the most predominant and frequently seen.

To take the safety and assured accuracy of your credentialing one step further, and to hopefully avoid these red flags, consider working with a vendor to handle the process for you.

Qualified, knowledgeable staff, and technology offerings are available to help with credentialing assignments. Expert vendors can offer tools that give you credential expiration reminders, templates for applications, task management and milestones to lead you through the process; all for easy workflow management.

Putting this important task in the hands of subject matter- experts can help alleviate the risk and save office staff time to focus on other equally important day-to-day business operations.

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