Credentialing is the process to verify and assess your medical education, training and experience. You will need to go through the credentialing process whenever you change employers or seek new privileges. It is one of the first steps young physicians will need to take when transitioning from training to practicing pediatrics. Some organizations outsource credentialing. This can be very helpful to the organization and to you especially when you may be overwhelmed with other onboarding tasks.
Typically, credentialing is a three-part process:
- Verification and assessment of your qualifications.
- Granting privileges to allow you to perform specific services at a hospital or institution.
- Enrollment in health plans to allow you to bill and be paid for those specific services.
When in the job search process, you should keep this information handy for certification purposes:
- A government issued photo ID usually a driver’s license or passport.
- Your education, training and board eligibility or certification. If you’ve recently finished your residency training and are waiting to take the exam to complete your board certification, a letter from your residency program director indicating when you completed your training should be sufficient.
- Clinical report cards and performance reviews.
- Your work, medical staff, and clinical privilege history.
- Names and contact information of colleagues, program directors or mentors who can and will provide timely references .
- Your malpractice insurance information. Be sure to include the name of the insurer, the policy certificate number, type of policy (occurrence versus claims-made), maximum individual and aggregate limits, and dates of coverage. Be ready to disclose a history of any malpractice claims.
- Your medical license. Every state requires a license to practice medicine. Maintain records of the license for the state in which you are currently practicing and the state where you plan to practice. Be sure to have a list of any past state medical licenses including those that are inactive. The Federation of State Medical Boards is a centralized resource for the contact information of each state board.
- Your national provider identification (NPI) number. This is separate and independent of records maintained by state licensing or specialty boards.
American Academy of Pediatrics