In healthcare, as in most sectors, providers are required to verify qualifications, training, and professional history. Credentialing updates refer to the continuation of this process throughout the staff member's term of employment with the organization. It is made up of both the initial credentialing and re-credentialing which reassesses existing credentials and continuing training.
What is credentialing?
Credentialing is a systematic process in healthcare that involves verifying qualifications, experience, and professional attributes of medical practitioners. A study published in the American Journal of Law & Medicine stated, “Credentialing systems dominated by organized professional interests in the health care industry have served not only as sources of useful information but also as important components of a larger professional effort to limit competition.” The process sets a standard for assessing a healthcare provider's eligibility to commit to healthcare delivery. There are typically several steps involved in credentialing namely:
- Submitting an application
- Verifying details in an application
- Peer references to assess competence and ethical standing
- A committee evaluates the gathered data against established standards
The reason behind credentialing updates
The primary reason behind the updates is the verification that practitioners continue to meet the standards of education as they evolve in their practice. The ongoing process addresses changes in a provider's qualifications while incorporating new regulations and advancements in medical knowledge. Examples of recent regulations that fit this criteria include:
- On April 22, 2024, the HHS Office for Civil Rights issued a final rule modifying HIPAA regulations to improve privacy protections for individuals seeking reproductive healthcare.
- A final rule effective February 8, 2024, aligns the Confidentiality of Substance Use Disorder Patient Records regulation with HIPAA.
Why HIPAA compliant email is the best way to share credentialing updates
HIPAA compliant email platforms are designed to ensure the security of sensitive information. Given that email-based hacking incidents are among the most common causes of data breaches in healthcare. Platforms like Paubox also provide additional features like Execuprotect that further secure against targeted cyberattacks. Features like these allow organizations to monitor who accesses information and provides a comprehensive access log.
Healthcare organizations can use HIPAA compliant email to communicate with staff members during requests for credentialing updates. As highly sensitive and valuable information is shared, these communications benefit from the wealth of security features like encryption while also accessing a convenient channel to share larger volumes of documentation. The use of HIPAA compliant email platforms also provides a log of all communications that can be used as evidence if discrepancies in credentialing are detected.
FAQs
What is the difference between privileging and credentialing?
Credentialing is the process of verifying a provider's qualifications, while privileging refers to granting specific clinical privileges to a provider based on their credentials.
How often should credentialing updates occur?
Credentialing updates should occur every two to three years but they can also be changes in a provider’s status.
Kirsten Peremore
