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What is healthcare credentialing? It’s the process of verifying that practitioners and organizations that provide healthcare services are qualified and competent to be affiliated with a healthcare organization. Hospitals credential their medical staffs and ancillary staffs, such as nurse practitioners and physician assistants. Managed care organizations credential practitioners and organizations that provide healthcare services to the members of their plans. Independent Physician Organizations (IPA’s) and Physician Hospital Organizations (PHO’s) credential their members in a two-fold manner, one to ensure that the healthcare providers are qualified and competent and two, to enroll those providers in a managed care plan it contracts with on their behalf. 

Healthcare professionals whose primary focus is to credential those healthcare providers (practitioners and organizations) are tasked with being the gatekeeper that protects the patients of those providers. This blog is dedicated to helping the patient make educated decisions regarding their healthcare plan by partnering with a professional that suits their needs. utilizing the some of the same data used by the healthcare organizations.

Other healthcare credentialing professionals are welcomed to comment and participate. This is the age of transparency. An overwhelming majority of healthcare providers provide excellent treatment and genuinely care about their patients. That's why healthcare providers who provide excellent care will be lauded as well as those with questionable practices reported here based on information from other credible sources. Check out Good News Docs and Bad News Docs pages on this site. However, it is the responsibility of any individual checking these pages to further investigate, should the information not be updated in a timely manner. This is only a starting point.  In addition to doctors or providers in the news, this site has links to licensing boards, board certifications, and sanction reports for your ease of investigation.

Partnering with the right provider is not the only activity we as patients should do, we have to actively participate in taking care of our health by following the advice of our healthcare providers.  So please visit here whenever you need to empower yourself through credentialing your provider.

This is a great place to start if you are relocating, seeking another opinion, or just not so happy with your provider. Pick up a copy of A Comprehensive Guide to Finding the Right Doctor: Tips from a Healthcare Credentialing Expert for its sole purpose is empowering the patient through credentialing.