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What Do Medical Residents Need to Know About Credentialing?

Medical residents should be proactive about credentialing during their final year of residency.

While you understandably have a lot on your plate as you finish your training, credentialing is one item you can’t afford to neglect during your job search. As the COVID-19 pandemic continues to adversely affect the job market, it’s imperative that you do everything in your power to prevent delays and obstacles to employment.

Below we cover some credentialing tips for medical residents, fellows, and new providers.

Medical Residents & Credentialing: 5 Things You Need to Know

1.) What is Credentialing?

First, it’s important to have a basic understanding of the credentialing process and all that it entails.

Credentialing involves verifying a provider’s qualifications (such as education, licenses, certifications, work history, and references). This includes primary source verification, which is the validation of a provider’s credentials through direct contact with the person or organization that originally issued the information.

Credentialing is a condition of obtaining employment, hospital privileges, and enrollment in health plans. Before you can begin practicing as a new provider, you will need to complete this lengthy process.

2.) Credentialing can take up to 180 days (or more, due to delays caused by the current pandemic).

The credentialing process often takes longer than expected. There are numerous people and entities to contact, and you must factor in the time it takes to follow up with those who fail to respond in a timely manner.

Some healthcare organizations will not schedule your employment start date until they have received all credentialing paperwork from you. For example, you may not be able to start working until 120 days or more AFTER you’ve submitted all (complete and accurate) requirements. This is why it is crucial to start the credentialing process as a medical resident – so that you can begin earning your salary as soon as possible.

3.) You should begin gathering all your credentialing information and documentation now.

Credentialing not only takes a lot of time, but is also an ongoing process. You will set yourself up for success if you:

  1. Do not procrastinate.

  2. Keep your records updated.

Having up-to-date and accurate information on hand will make the credentialing process much more efficient and less painful for you. If a potential employer, hospital, or payer needs any material from you, you want to be able to access it ASAP.

Take particular care to secure your professional references ahead of time. It’s a good idea to obtain more references than are required so that if one cannot be reached it won’t hold up the rest of your application.

4.) One of the biggest credentialing errors is missing or incomplete information.

When filling out your applications, be sure to complete them precisely and in full detail. Don’t leave out any information that is asked for, as mistakes and omissions will result in delays.

Before submitting it, check your paperwork multiple times and have another experienced professional look it over to make sure you are not missing anything. Then, make sure you follow up on the status of your application at least weekly. This will ensure you detect and resolve any deficiencies right away, since many states allow 60 days or more for payers to inform you of errors.

5.) Expect delays if you wait until the summer to start the credentialing process.

Remember, there are plenty of other medical residents completing their training at the same time as you. Payers are especially busy in the summer because they receive a lot of applications in the months following graduation. Get a head start on the competition by preparing your credentialing work now and avoid the application delays that will inevitably occur due to high volume.

Credentialing Services for New Providers

As you can see, credentialing is complex, time-consuming, and exhausting. As a medical resident or fellow, your time is precious. Adding a job search and credentialing work to an already packed schedule can seem overwhelming.

EligibilityOne is here to help. We can manage the entire credentialing process for you, so that you can focus your time and energy on completing your training and finding a job you will love.

Our services include CAQH registration, credentialing, hospital appointment, provider enrollment, monitoring and maintenance, and more. We develop long-term relationships with our clients – assisting new providers in a smooth transition from residency or fellowship to employment in their profession and helping them maintain compliance throughout their careers.

Contact us to start the credentialing process or to learn more about how we remove the burden of credentialing for medical residents, fellows, and new providers nationwide.


By Stephanie Salmich


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