Significance of Physician License Renewal

If you're a healthcare facility owner or credential manager, there's one mistake you absolutely must avoid – onboarding medical personnel with fake credentials into your system. The repercussions of such an error are severe and can cost your healthcare facility its credibility, not to mention the potential harm to patient safety.

In the realm of healthcare, primary source verification emerges as a critical component of the credentialing process. Before physicians, nurses, and other medical staff can practice at a healthcare facility, they must undergo a rigorous credentialing process. This process, while extensive, is vital to ensure that only qualified and genuine healthcare providers are granted access to the facility.

As part of routine preparations for accreditation surveys, it's crucial for the credential manager to effectively organize and manage the credential information of all medical staff within the facility. It's the linchpin to ensuring accuracy in personnel credentialing documents, and it can't be underestimated.

What Exactly is Primary Source Verification?

In simple terms, Primary Source Verification (PSV) is the process of verifying the credentials of a healthcare provider directly with the source. These credentials include state or federally-required certification, licensure, training, and education. It's a meticulous process that involves contacting the source of the credential for verification through methods such as mail, telephone calls, and other secure electronic communication channels.

To highlight the significance of PSV, one of the main accrediting bodies in the United States, The Joint Commission, mandates that it must be performed at the time of hiring and renewal. Furthermore, the health provider's license must remain in good standing throughout their employment.

Distinguishing Between Primary Source License Verification and Medical Credentialing

It's essential to clarify the distinction between primary source verification and medical credentialing. While medical credentialing ensures that healthcare providers possess the right training and experience to offer healthcare services to patients, primary source verification focuses on the verification of a healthcare provider's credentials directly with the issuing authority. In other words, PSV is one of the major processes that must occur during medical credentialing.

Who or What is Considered a Primary Source?

A primary source refers to the issuer of the credential document. For example:

1. The primary source for your medical education is your medical school, not your certificate.
2. The primary source for a DEA License is the Drug Enforcement Agency.
3. The primary source for board certification is the issuing board.
4. The primary source for postgraduate training is the predoctoral programs within a residency.
5. The primary source for a state medical license is the Issuing State Licensing Board.

As a diligent credential manager, you should not accept any verification document directly from the physician under verification. No third party should be involved in validation unless it has been certified by the accreditation organization.

The Critical Need for Primary Source License Verification in Healthcare Organizations

The foremost priority of every healthcare organization is to ensure patient safety and primary source verification plays a pivotal role in achieving this objective. There are instances where unlicensed and unqualified individuals pose as legitimate medical practitioners, using fake college degrees, falsifying resumes, or forging licenses to secure employment. Without PSV, it would be virtually impossible to authenticate the legitimacy of the credentials provided by healthcare providers.

Employing an unlicensed or fraudulent practitioner poses a substantial liability risk to the healthcare organization. The penalties and sanctions for such lapses can be overwhelming, and organizations must exercise utmost diligence to prevent unqualified practitioners from slipping through the cracks. The bottom line is this: no provider should be employed without the requisite credentialing through primary source verification.

Which Credentials Require Primary Source Verification?

The Joint Commission, responsible for the accreditation of most U.S. hospitals and health systems, mandates accredited healthcare organizations to use primary sources for verifying specific credentials. These include:

1. Medical Education
2. Board certifications
3. Training and residency programs
4. State medical licenses
5. Federal and state DEA certificates
6. Hospital affiliation
7. Military board personnel
8. Medical malpractice history
9. Work history

The Joint Commission does not explicitly require primary source verification for other credentials, such as professional history, letters of recommendation, criminal background checks, identification verification, immigration status, and financial documents unless specified by the hospital's policy. However, it is strongly recommended that hospitals embrace the practice of primary source verification for these credentials as well, both as a best practice and to safeguard against appointing a practitioner who submitted fraudulent credentials.

For payer organizations, the National Committee for Quality Assurance (NCQA) sets the quality standards regarding primary source verification.

Traditional Methods of Primary Source Verification

Accrediting bodies like the Joint Commission, GL, Det Norske Veritas (DNV), and Healthcare Facilities Accreditation Programs (HFAP) mandate healthcare organizations to engage in primary source verification in adherence to their standards.

Traditionally, primary source verification often involved significant human resources and administrative effort to perform verifications through manual license lookups. While many primary sources and state boards now maintain electronic databases with certification and license information accessible on secure websites, not all have transitioned to the digital realm.

In cases where digitization is lacking, verification is carried out through traditional means, such as telephone calls, written correspondence, or electronic fax. It's a time-consuming process that can be labor-intensive, but it is absolutely essential.

A More Efficient Approach to Primary Source Verification Process

Primary source verification doesn't need to be a daunting and time-consuming task. Changes in licensure status can occur unexpectedly, making it insufficient to verify only during hiring and renewal.

The best approach is to verify as often as possible, and Credidocs can automate this process, keeping all medical credentials in one centralized location while staying on top of requirements and expiration dates.

Credidocs offers the fastest and most efficient way to onboard new providers while ensuring primary source verification and ongoing monitoring are seamlessly integrated into a state-of-the-art software platform.

By embracing innovative solutions like Credidocs, healthcare facilities can not only ensure their compliance with regulatory standards but also promote patient safety and secure the trust of their patients.

Contact us today to learn more about how Credidocs' solutions can revolutionize your credentialing process, ensuring accuracy, compliance, and the highest standards of patient care.

Imagine spending months diligently recruiting a much-needed physician for your practice, setting up the office, hiring staff, and eagerly scheduling patients. Everything seems perfect until the entire operation comes to a grinding halt due to credentialing issues. The frustration can be overwhelming, and the financial toll it takes can be quite substantial.

This scenario is far too common and, unfortunately, quite expensive. One industry source estimates that the loss of revenue due to physician credentialing delays can amount to a staggering $7,500 per day. It is merely the beginning, with much more beneath the surface. Practice overhead costs, including staff salaries and the doctor's income guarantee, pile up each day. On top of that, there are increased staff hours and annual database expenses. It all adds up quickly.

Here's the harsh reality: handling your own credentialing is a time-consuming and costly endeavor. Let's explore how automating this task can help you avoid wasting valuable time and resources so that you can focus on patient care.

The High Cost of Handling Credentialing In-House

Physician credentialing is a critical process that can significantly impact your practice's financial health when not handled accurately and promptly. While successful credentialing can attract new patients and increase revenue, the process itself can be burdensome and expensive.

Consider these costs:

1. At an estimated rate of $100 per hour, credentialing work for a physician can cost approximately $20,000 per year.
2. Additional expenses related to office staff involvement, taxes, and other overhead costs further inflate the financial burden.
3. Incomplete or erroneous applications can lead to additional expenses.
4. Lost revenue also factors in:
5. Time spent on credentialing services instead of with patients
6. Efforts to resolve application and submission issues
7. Supervising credentialing work

The manual credentialing process typically spans about 180 days, broken down as follows:

1. 30-60 days for onboarding and documentation.
2. 90-180 days for primary source verification and exclusion assessment.
3. Approximately 4-8 hours per provider/payer for tasks such as payer enrollment, facility privileging, provider profile management, CAQH profile management, payer calls, and payer market research.

Studies reveal that physicians spend a substantial amount of time on paperwork and administrative tasks, detracting from valuable patient interaction. In fact, some physicians may dedicate up to 4 hours per week to credentialing alone, not accounting for other administrative responsibilities or time spent by office staff.

In reality, the cost of in-house physician credentialing is likely much higher than the estimated $20,000 per year. So, how does this compare to automating the credentialing process? Let's take a closer look.

The Cost of Automating Physician Credentialing Services

It's important to note that the cost of credentialing services can vary based on several factors, including your current credentialing status, the number of physicians you plan to add, the pace at which your practice grows, and any additional services you require from your credentialing provider.

By connecting with a physician credentialing company like Credidocs, you can expect to pay an average of $500 for physician credentialing services. Similarly, hospital credentialing by Credidocs costs $200 only.

The utilization of the CAQH database helps streamline information collection for the credentialing process. Management costs will depend on the level of involvement your credentialing provider has and how frequently updates to the database are needed.

If you're yearning for a few extra minutes with each patient, partnering with medical credentialing services like Credidocs may be the solution you've been seeking. Let's explore four benefits for you and your private practice.

4 Ways Medical Credentialing Services Save Time and Money

1. More Time with Patients, Less Paperwork: You became a physician to make a meaningful impact on patients' lives, not to drown in paperwork. Physician credentialing services alleviate some of this administrative burden, allowing you to focus on what truly matters – your patients. Increased one-on-one time with your doctor leads to happier patients, contributing to a thriving practice. Automating credentialing reduces redundancy and streamlines the process
2. Expert Handling of Payments: Navigating the credentialing process requires finesse. Experienced professionals can navigate the complexities smoothly and circumvent potential roadblocks. They ensure that applications are accurate and complete, sparing you the hassle of revisiting missed sections or crucial details. With accurate submissions and efficient follow-ups, payments flow smoothly, and bureaucratic obstacles are minimized.
3. Automatic Monitoring and Updates: Credentialing providers automatically maintain and update your CAQH profile. Credentialing software has the ability to send automated alerts, execute batch processing, and build audit trails.
4. Integration with Other Services: Credentialing services are just one facet of practice management. Some credentialing companies also offer additional services such as FCVS setup, license renewal, IMLC state addition, etc. This holistic approach streamlines operations and ensures that your practice is being managed efficiently. You receive regular status reports and full access to all documents, providing peace of mind. Moreover, you benefit from dedicated support, promptly addressing any questions or concerns.
5. Reduce operational costs - According to the Medical Group Management Association (MGMA), physicians spend approximately $7,618 annually to submit credentialing applications. A credentialing software solution like Credidocs can significantly reduce operational costs.
6. Database maintenance - Maintaining physician details as an extensive database can be challenging, especially for practices with limited human and financial resources. Credentialing software offers a cost-effective solution.

Thus, automating the credentialing process can save physicians approximately $29,000 annually and free up approximately 3 hours spent regularly on credentialing tasks. This translates to more resources for patient care and infrastructure improvement.

Why Choose Credidocs?

Partnering with physician credentialing company like Credidocs offers numerous advantages:

1. Ensuring providers stay on the certification radar, reducing the initial credentialing time from five to two days.
2. Decreasing denials by flagging any discrepancies between physician network participation approval and insurers.
3. Accelerating the credentialing of new providers, such as those coming from residencies or fellowships, in less than 30 days with automated intake features.

Auto-credentialing not only cuts costs but also delivers faster results. Credidocs is vendor-agnostic, seamlessly integrating with all platforms.

Final Thoughts

Ready to reclaim your focus on what truly matters? Connect with Credidocs and explore the possibilities of medical credentialing services right away!

When it comes to dealing with certain issues, seeking the help of those who have already faced the same problem can be highly beneficial. This holds true for the renewal of medical licenses, as there are numerous licensed services available to assist with this process.

Therefore, if you are a doctor in need of license renewal, utilizing medical license services may be the right path for you. Failing to renew your medical license in a timely manner can result in severe consequences.

To ensure that you can continue providing medical care without any complications, it is crucial to always renew your license on time. It is advisable to not even wait for the grace period provided for license renewal.

Should you consider renewing your license with a physician licensing service?

Yes. There are various companies and services, such as Credidocs, that specialize in helping doctors and nurses with their licensing needs. Delegating the responsibility of renewing your license to such a service can free up your time for other important tasks. However, you may wonder if it is worth the investment and if you can trust someone else to handle this task on your behalf. Here are several reasons why many doctors opt for medical licensing services:

1. Tailored solutions: Before placing an order, you will be required to complete an application that allows you to provide the service with all the necessary details. This ensures that the professionals assisting you have all the information they need to help with your license renewal.

2. Speedy renewal process: As you may already know, the renewal process can be time-consuming. By working with a trustworthy licensing service, you can be confident that your license will not only be renewed on time but possibly even earlier.

3. Stress-free experience: Let's be honest, renewing your license can be a stressful and exhausting endeavor, especially if it is your first time going through the process.

4. Comprehensive assistance: Physician licensing services like Credidocs take care of every aspect of your license and renewal process, alleviating the burden of paperwork from your shoulders.

5. Expert guidance: Successfully renewing your license requires a deep understanding of state laws and government requirements. By partnering with a highly reputable physician license service, you can rest assured that you will be supported by knowledgeable professionals who are well-versed in these matters. Additionally, you will have the opportunity to ask any questions you may have.

6. Guaranteed success: The key to a successful license renewal lies in choosing the right physician licensing service. If you make the right choice, you can have peace of mind knowing that you are likely to renew your license swiftly on your first attempt. Moreover, you can oversee the entire process and provide feedback to the service if you wish to make any changes or additions.

What happens if your medical license expires?

If your medical license expires, you will be prohibited from legally practicing medicine in the state. This interruption can have several negative consequences, even if it is only temporary:

1. Patient Care: Patients who require medical treatment will not be able to receive care from you. Even if another physician is able to take over, the continuity of care will be disrupted.
2. Personal Earnings: If a significant portion of your work involves clinical care, being unable to render care means you will not be able to earn income. This can result in not receiving a paycheck for the duration of the license expiration.
3. Professional Liability: Practicing medicine with an expired license puts you at a substantial risk of liability. If something goes wrong during a patient's care, they may have a strong case against you, and your expired license could potentially nullify your medical malpractice insurance.
4. Professional Reputation: While you may be able to hide a short lapse in licensure from patients by attributing it to vacation or personal days, you won't be able to hide it from all of your colleagues. They will want to know what happens if you claim vacation, and your license renewal application will be reviewed by some of your professional peers.

Any lapse in your medical license can be inconvenient, embarrassing, and costly.

When are medical license renewals due?

The renewal period for medical licenses varies by state, as each state has its own requirements. In some cases, medical doctors and doctors of osteopathic medicine may have different renewal dates within the same state.

Generally, most states require medical licenses to be renewed every one or two years. Some states allow for a three-year gap between renewals. Common deadlines for renewals are December 31, January 31, birthdate/month, June 30/July 1, and October 30/November 1. These dates are just a few examples of more common deadlines.

Some states have different dates based on your last name (e.g., West Virginia, Ohio) or specific departments (e.g., Alaska). Additionally, some states may have a grace period for medical license renewal, although this can vary. Our Credidocs website provides helpful information, but these few details illustrate the complexity of license renewal due dates.

How do physicians renew their medical licenses?

Checking your current license status is often the easiest approach. Physicians must go through a process to renew their medical license. The process varies depending on the state and can involve completing continuing education hours, submitting a form, and paying a fee.

Each state has its own application requirements and review process, so the timeline for renewal can vary. If a license expires due to procrastination or forgetfulness, the process becomes more complex.

In these cases, a higher fee and additional paperwork may be required. For prolonged lapses in licensure, a clinical skills assessment and/or physician assessment may be necessary.

Physician License Renewal Simplified

To simplify the renewal process, Credidocs can manage your renewals for you. They will notify you of your specific renewal due date and handle all the paperwork with state medical boards. With their expertise in working with licensure boards in all 50 states, they ensure that you are properly licensed to provide medical care.