The rise in popularity of medical credentialing services may have given you the idea to put up your own medical credentialing business. That’s a great start because health care is a delicate industry that requires precision and accuracy, and medical credentialing has proven to be very efficient in achieving that goal. However, with the wide scope that the credentialing process entails, you may need the help of medical credentialing books to guide you on what will be the best practices you need to implement for your new business.
What Exactly Is Medical Credentialing?
Medical credentialing is the process of acquiring the necessary information about a physician or any other medical professional to substantiate his or her qualifications, educational backgrounds, licences, and certifications to legally practice within a specific medical field.
This process is very exhaustive and time-consuming because it involves going to the primary sources of the:
- Medical Education
It will confirm that the medical practitioner indeed went to the claimed medical school or other medical institutions for his or her medical and post-graduate studies,including the number of credits and hours rendered, to serve as evidence, etc.
The credentialing process must also verify the number of hours that the doctor rendered for his or her internships, fellowships, and residencies in the specified hospitals and other medical facilities.
- Board Certifications
The doctor must be a certified board passer. Other certifications the doctor presents will also be assessed for authenticity by contacting the specific board or organisations that gave them.
Government licences are also scrutinised for their truthfulness. All other licences that the medical practitioner will provide also needs tobe verified for authenticity.
Medical Credentialing Books to Help You Become a Certified Specialist
If you are starting your own medical credentialing business, it is best if you are a Certified Provider Credentialing Specialist yourself or can hire one who is. In order to become an eligible candidate for the medical credentialing certification exam, you have to be currently working within the medical services field for at least 1 year during the time of your application and you need to have a total of 3 years’ working experience in the same field for the past 5 years.
Having a Certified Credentialing Specialist in your business is extremely beneficial because the Specialist is the one responsible for many key procedures for your medical credentialing business. He or she is tasked to do the following:
- To maintain your business’ compliance with important regulatory and accrediting bodies of your state or country.
- To participate in developing and implementing important credentialing processes and procedure, including new techniques and methods.
- For the collection and maintenance of an accurate database of practitioners and then analysing the verification of information.
- To participate or oversee the development and adherence of your business to:
- Department laws and regulations;
- Governing bylaws; and
- Policies regarding medical staff, other health practitioners, and the organisation
There are many booksthat can help you pass the medical credentialing certification exam, and also improve your knowledge and understanding of the medical credentialing process. Some of these helpful books and guides include the following:
The Credentialing Handbook by Sheryl K Deutsch and Christine Mobley
This handbook offers a comprehensive guide on helping you better understand and master the whole medical credentialing process for any health care setting. It contains checklists, flowcharts, sample forms, and other correspondences related to the medical credentialing process. It aims to give you a practical walk-through on every aspect, from the application for credentialing, to appointment setting, and even the re-credentialing procedure.
Physician Credentialing and Peer Review Answer Book by The Aspen Health Law Centre
This book provides in-depth information on the mechanics of hospital credentialing process, which includes the involvement of the hospital’s medical staff, administrative personnel, and its board of trustees. It also discusses guides on dealing with subjective judgment for the hospital administration, such as hiring a health practitioner with disciplinary history and what privileges can be given to that health care practitioner. The process of the re-credentialing is also discussed here.
Physician Credentialing: A Guide for Physician Office Staff by Veronica Rosas, CPCS
This is a resource book that teaches you all the important steps of the medical credentialing process. It provides you with effective techniques on how to maintain current credentials for health care providers who are currently employed and are given privileges by a hospital, or other medical facilities. It also tackles the proper ways to manage the credentialing of new physicians.
Attempting for Excellence in the Medical Credentialing Business
Since medical credentialing is a daunting process that imposes strict compliance, your business will be able to persist through various trying times if you constantly attempt for high quality and excellent medical credentialing services. This starts with extensively knowing the basic but extremely important process of medical credentialing certification. Learning from books can certainly go a long way in instituting a strong foundation for your new business.