Credentialing Definition

Credentialing in healthcare refers to the process of verifying and evaluating the qualifications and professional history of healthcare providers, ensuring they meet the standards set by hospitals, insurance companies, or regulatory bodies. It involves verifying credentials such as education, training, licensure, and any specialized certifications that are required to practice in a particular healthcare field.

Healthcare organizations, insurance companies, and government agencies require credentialing to ensure that providers are competent and qualified to deliver safe and effective care to patients. Credentialing also involves ongoing monitoring of providers to ensure they maintain their qualifications and comply with professional standards and regulations. This process helps protect patient safety, maintain quality of care, and uphold organizational and regulatory requirements in healthcare settings.