What Is Credentialing?
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.
Why Does Inova Credential?
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.
Can a Physician or Other Practitioner Admit, Attend or Have Other Patient Contact in the Hospital or Another Inova Facility Before Completing the Credentialing Process?
No, a practitioner cannot have any patient contact while waiting for the completion of the credentialing process.
How Does a Practitioner Get Credentialed and Request Privileges at an Inova Entity?
For information see Application for Privileges.
How Does a Practitioner Update Their Profile Information Such as Submitting a Name Change or Office Address Change?
Complete the Practitioner Change Form and submit it to the Centralized Credentialing Department via email or fax.
Initial Application Questions
How Far in Advance of My Start Date Should I Begin the Credentialing Process?
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.
Is There Anything a Practitioner Can Do to Speed up the Application Process?
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.
How Do I Submit a Credentialing Application?
If I Am Already on Staff at an Inova Entity, How Do I Apply to Another Inova Entity?
If I Am Already on Staff at an Inova Entity, How Do I Request Additional Privileges at That Entity?
What Is Reappointment?
Reappointment is the process of re-evaluating a practitioner's current competency after they have been appointed to the medical staff or professional staff.
Once I'm on Staff, Why Do I Need to Go Through the Paperwork Again?
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.
What Happens If I Don't Complete My Reappointment Paperwork?
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.
What Are Expirables?
Expirables include a practitioner's:
- License to practice
- Malpractice insurance
- DEA certificate
- Board certification
How Can I Get More Information on the Expirables Process?
See Expirables for detailed information.