Medical credentialing is a process to evaluate the qualifications and practice history of a doctor to establish competency. This process comprises a review of a doctor’s completed education, training, residency, and licenses. It also includes any certifications issued by a board in the doctor’s area of specialty. Hospitals, insurance providers, Medicare and Medicaid conduct medical credentialing to determine which physicians meet their requirements prior to permitting them to practice in their network. These entities continue to do so, on a regular basis as dictated by states, regulatory bodies and accrediting organizations.
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