Credentialing

Setting the Tone: Professional Standards Start with Leadership Healthcare organizations rely on Provider Lifecycle Professionals (PLPs) to keep essential processes running—credentialing, licensing, provider enrollment, and quality. These functions directly affect patient care, provider access, and organizational compliance. But technical accuracy isn’t the only standard that matters. Professionalism—how PLPs present themselves, communicate, and manage responsibilities—shapes how

In a field defined by regulation, deadlines, and constant change, resilience isn’t optional—it’s essential. Provider Lifecycle Professionals (PLPs) face daily pressure to meet onboarding targets, navigate payer requirements, and manage shifting policies. Burnout is a real risk. That’s why building a resilient PLP team is one of the most powerful investments an organization can make.Resilient

For Provider Lifecycle Professionals (PLPs), reappointment is more than just a routine task—it’s a high-stakes process that safeguards patient safety, ensures regulatory compliance, and protects organizational reputation. Yet despite its importance, the reappointment process can be one of the most error-prone and stress-inducing areas in credentialing. Tight timelines, missing documents, and communication breakdowns can all

Credentialing is a critical function in any healthcare organization but, in multispecialty practices, it becomes significantly more complex. With a wide range of specialties under one roof, credentialing teams must navigate competing timelines, differing privileging requirements, and large volumes of provider data, all while ensuring compliance and consistency. For credentialing professionals, success depends on process

One of the most frequently asked questions in medical staff services is, “How long does credentialing take?” The answer, of course, depends on the type of healthcare setting, the complexity of the practitioner’s credentials, and the thoroughness of the process. For Provider Lifecycle Professionals (PLPs), understanding and effectively communicating these timelines is key to setting

The credentialing process is built on precision, accountability, and timeliness. Yet one critical step often gets overlooked in the rush to move on to the next task: closing out the file. Once the board has approved an initial appointment or reappointment, the work isn't truly complete until the file is closed—and that should happen within

Credentialing is a complex, multi-step process, but the way we document approvals doesn’t have to be. When signatures pile up unnecessarily or processes vary from one file to the next, the approval pathway becomes unclear and inefficient. Streamlining how we document credentialing decisions isn’t just a matter of preference—it’s a necessary step toward greater clarity,

Delegated credentialing is more than an operational efficiency—it’s a strategic approach that benefits healthcare organizations, providers, and payers alike. By shifting responsibility for the credentialing process to trusted organizations, payers streamline workflows while maintaining oversight through rigorous standards. For Provider Lifecycle Professionals (PLPs), delegated credentialing represents an opportunity to demonstrate their expertise while enhancing the

Trust forms the foundation of healthcare. When patients enter a medical facility, they’re placing their well-being, and sometimes their lives, in the hands of professionals they may have never met before. They trust that these professionals are skilled, licensed, and competent. In this complex environment, credentialing—verifying and vetting healthcare practitioners’ qualifications—plays a critical role in

Delegated credentialing can feel intimidating to both new and seasoned MSPs in managed care, hospital, or CVO environments. But the intimidation is replaced with confidence once you understand the foundations of the delegated credentialing process. Here are the six steps necessary for successful delegated credentialing: Facility contract: The group or facility must have an existing

When I was a newbie, I learned a central lesson about credentialing: that to ensure compliance with the standards, the primary source verification documents I obtained for a practitioner were for my facility only, and peer review information was confidential. That changed when shared services agreements began to take hold. Over the years, four trends