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What is Medical Credentialing, and Why is it Important?

Five reasons why practices need to have medical credentialing and why it is so important.

By Stephen O'Connor | 5 min | 04 February 2021

Medical credentialing verifies that nurses and doctors are properly trained and certified and have the required professional experience to provide healthcare services to patients. It’s a crucial aspect of maintaining high standards of safety in the medical profession.

From a financial perspective, organizations typically cannot obtain reimbursement for provided services from insurance entities including Medicaid/Medicare if they lack medical credentialing.

Without medical credentialing, it can be extremely difficult to work with any healthcare software solutions. No forward-looking medical practice or healthcare provider can ignore medical credentialing and expect to thrive in this industry.

As Healthcare Innovation reported, “Medical credentialing is increasingly important because it is the one procedure that allows patients to confidently place their trust in their chosen healthcare providers.”

Since medical credentialing is the process that lets us know doctors and nurses have proper training and experience to practice the healing arts, it’s incumbent on healthcare organizations to have a good understanding of medical credentialing.

The process of medical credentialing began as far back as 1,000 BC. when the Cult of Zoroaster mandated that physicians treat three heretics. If all three lived, the doctor would be qualified to treat patients until the end of his or her career, according to Continuum. We’ve come a long way since the method used to credential doctors in ancient Persia, but the underlying theory is the same: To make sure medical professionals are qualified to treat patients.

To help you address this topic with your colleagues, here are five reasons why practices need to have medical credentialing and why it is so important.