General Questions

Credentialing is a term that usually encompasses two separate processes: credentialing and privileging. Credentialing is the primary source verification of a health care practitioner's education, training, work experience, license, etc. Privileging is granting approval for an individual to perform a specific procedure or specific set of privileges based on documented competence in the specialty in which privileges are requested.

Inova, like other health care organizations, is legally responsible for knowing that individuals providing patient care are qualified and competent to do so. The Joint Commission, The Centers for Medicare and Medicaid Services (CMS), National Committee on Quality Assurance (NCQA), the Virginia Department of Health and other oversight organizations require that members of the medical and advanced practice staff be credentialed and privileged before working in the facility.

No, a practitioner cannot have any patient contact while waiting for the completion of the credentialing process.

Initial Application Questions

Most healthcare organizations advise submitting an application 90 to 120 days before a practitioner's start date. Ninety to 120 days is a benchmark because it allows extra time when verification sources do not respond in a timely manner or clarification of discrepancies is required.

Yes. Practitioners can greatly influence the length of processing time by contacting their verification sources and asking each source to respond to Inova's verification requests as soon as possible.

Reappointment Questions

Reappointment is the process of re-evaluating a practitioner's current competency after they have been appointed to the medical staff or professional staff.

The Joint Commission hospital accreditation standards require all practitioners to complete a reappointment process every 24 months. Inova has a duty to ensure that all practitioners on staff are currently competent, and reappointment is the process of re-evaluating competency.

If a practitioner does not complete reappointment paperwork on time, the practitioner's reappointment will expire and they can no longer work or see patients in an Inova entity.

How can I get more information on the reappointment process?

See Reappointment for detailed information.

Expirables Questions

Expirables include a practitioner's:

  • License to practice
  • Malpractice insurance
  • DEA certificate
  • Board certification