Why is credentialing important?

Without credentialing, it is not possible for healthcare professionals to perform services and be reimbursed for their time. Everyone—from hospitals and out-patient surgery centers to providers seeing patients in an at-home setting—is at one point required to file a credentialing application. This process begins with your application for licensure, and continues through applying for DEA certification, controlled substance registration, obtaining hospital and clinic privileges, contracting with insurance payers, and enrolling in Medicare and/or Medicaid. It is required by accreditation and regulatory agencies like Medicare, The Joint Commission, and the National Committee for Quality Assurance.