| Most doctors tend to place their residency and | | | | The reviews are expected to be fair, reasonable, |
| medical school diplomas on their office walls for all | | | | arbitrary, performed in good faith, justifiable, have |
| to see because it necessary that their patients | | | | extensive documentation, and equally applicable to |
| feel that they have come to a reliable doctor and | | | | all. The decisions made regarding doctor |
| are in the safe hands of an experienced health | | | | credentialing should be protected and confidential. |
| professional. Though these diplomas are definite | | | | In cases where there are adverse decisions being |
| signs of accomplishment for physicians and health | | | | made, certain avenues of appeal and the inclusion |
| practitioners, they don't necessarily guarantee | | | | of legal hearings are expected to be made |
| quality. In order to provide this guarantee, a | | | | available to the doctor who is being assessed. |
| stringent, although not federally required, legal | | | | There are certain professional standards when |
| process has been created wherein health | | | | credentialing a doctor and these include whether |
| organizations and physicians can become | | | | or not he or she provides quality and timely |
| accredited in order to provide doctor credentialing. | | | | medical care, whether there over or under |
| Credentialing physicians is the formal process of | | | | utilization of medical resources, and so on. |
| attestation and recognition of the current medical | | | | Patient referrals to physician specialists or |
| and technical competence as well as performance | | | | outpatient clinics are generally not considered as |
| of a doctor by monitoring and evaluating his or | | | | important factors in the physician credentialing |
| her medical or clinical decision-making abilities. | | | | process. During the process of physician |
| Furthermore, physician credentialing verifies | | | | credentialing in the United States, everything from |
| medical education, certification, training, license, | | | | hospitals, HMO and the state boards of licensure, |
| experience, malpractice, technical abilities, clinical | | | | to the managed care entities and different |
| judgment, and if any, adverse clinical occurrences | | | | organizations have to address two main issues. |
| through observation and investigation. | | | | One issue deals with factors that confirm the |
| A doctor's credentials describe the scope of | | | | physician's background information, like graduation, |
| medical practice and the clinical services that he or | | | | residency, and whether or not the certification is |
| she provides. It also ensures that the doctor is | | | | valid. The second issue deals with the physician's |
| provides services that are of a desirable standard. | | | | special request for the rights to provide care for |
| Doctor credentialing is the product of certain | | | | a select spectrum of patients. A lot of healthcare |
| objective peer reviews that utilize criteria | | | | facilities and even doctors today are finding |
| established through common professional, | | | | themselves entangled in malpractice suits for |
| administrative and legal practices. The criteria are | | | | incompetence or for hiring incompetent physicians. |
| usually directly related to quality of health care | | | | Thus certain legal processes have been designed |
| and the performance of the concerned physician. | | | | for effective doctor credentialing. |