SCI Anesthesia's Guide To Credentialing

In the locum tenens world, credentialing is one of the most crucial yet challenging aspects to onboarding new providers. This is why it is important that every provider takes the necessary steps to educate and prepare themselves. With over 20 years of anesthesia staffing experience, we have seen credentialing eveolve – in some cases for the better, in some for the worse. In this guide, we will talk about the intricacies of credentialing, different processes, and tips to ensure a smooth experience, particularly in the locum tenens staffing agency world.

What is credentialing?

Credentialing is the process by which a hospital or surgery center evaluates your application and grants you the privileges to provide anesthesia services at their facility. In anesthesia, there are typically two types of credentialing:

1. Facility Credentialing: Managed by the medical staff office, this process grants you the privilege to work at a specific facility.
2. Enrollment Credentialing: Managed by a billing department or third-party entity, this process enables billing various patient health insurance providers for anesthesia services.

When undergoing credentialing at a facility, you may be contacted by multiple entities requesting the same information. Ideally, if you are working through a staffing agency, they will act as a liaison, assisting in gathering your supporting documents, preparing applications, and following up with all parties involved.

Is every credentialing process the same? 

Approximately 75% of credentialing processes are similar, though there are slight variations depending on the facility’s rules and regulations. Outpatient facilities, surgery centers, and smaller hospitals typically have shorter credentialing processes compared to larger hospital systems, which can be more extensive. Variations in the process can be attributed to differing facility ownership, management interests, and state regulations.

How long does credentialing typically take? 

Credentialing typically takes anywhere from 1 to 4 months, with an average of about 2 months for locum tenens providers. Some facilities can credential very quickly, usually for outpatient facilities or hospitals in dire straits issuing emergency privileges. With most locum tenens assignments, the providers were needed yesterday and do not always go through the same credentialing process for permanent staff members prior to starting the job. In these cases, there is a smaller list of items and verifications that can be issued for “temps” for a certain period. Temps are typically issues for 90-180 days (about 3-6 months). At the end of the temporary term, they are either extended or full staff privileges are given.

Preparing for the Credentialing Process:

To ensure a smoother credentialing process:

1. Keep your CV Updated: Ensure all work history and education is listed chronologically.
2. Organize Supporting Documents: Store them in an easily accessible digital folder that can be shared with agencies and hospitals.
3. Maintain Detailed Case Logs: Keep records of your procedures.
4. Retain Certificates of Insurance: Keep copies from previous jobs.
5. Request a Phone Interview: Speak with someone clinical on site to get feedback on the job and the credentialing process.
6. Gather Contact Information: Keep email addresses and phone numbers from previous jobs and educational institutions for verification.
7. Ask Questions: Before booking an assignment, inquire about the duration and specifics of the credentialing process:
   1. Have you credentialed anyone at this location before?
   2. How long does it typically take to process my application once submitted?
   3. Do you have a copy of the required supporting documents?
   4. Will the hospital begin the process with partial documentation?
   5. Does the facility issue temporary privileges, or will I receive full staff privileges?
   6. How often does the credentialing committee meet, and what are the deadlines?

Pitfalls To Avoid:

1. Delays in Paperwork: Submit all requested documents promptly to avoid state date delays.
2. Frustration with Redundancy: Understand that primary source verification is necessary. Hospitals need to verify with your previous employers, references, and educational institutions, which can vary from facility to facility.
3. Lack of Process Understanding: Familiarize yourself with the facility’s credentialing process to avoid misunderstandings. Numerous variables can affect the process, and being informed can help navigate it more efficiently.

Tip: Stay proactive by asking questions and maintaining regular communication with your agency. Do not assume your file is on track without confirmation.