How do credentialing and medical staff roles differ?

I received a question today from one of our Cactus users asking about the difference between the role of a credentialing coordinator and a medical staff professional.  I'd like to share the answer to that question in the blog today, as well as address the difference between credentialing and privileging.

In general, someone in a credentialing coordinator / professional role is responsible for the management of credentialing functions within the healthcare organization. The person in this role is responsible for maintaining an accurate practitioner database. A credentialing coordinator should have knowledge of the accreditation standards and legal regulations that govern credentialing healthcare professionals. He or she is also involved in the development of credentialing policies/procedures within the organization.MS-Coordinator.jpg

Compared to the duties of a credentialing coordinator, a medical staff coordinator / professional is responsible for oversight of medical staff adherence to hospital and medical staff bylaws, rules and regulations, and policies. A medical staff coordinator/professional role is specific to healthcare organizations that have an organized medical staff. Those in this role frequently collaborate with medical staff and organization leadership within the scope of their responsibilities.

These definitions should help clarify the difference between these two important processes in healthcare organizations.

Credentialing is the process of obtaining, verifying, and assessing individual healthcare practitioner qualifications to provide patient care services in or for a healthcare organization.

Privileging is the organization’s process of granting authorization to a healthcare professional allowing them to provide a specific clinical scope and content of patient care service. Granting a privilege is based on evaluation of the individual’s credentials and performance.

To learn more about how to make credentialing, recredentialing, and privileging easier for your organization, view our recent webcast.

Credentialing, Recredentialing and Privileging Basics Download

 


Jan Laws

About the Author
Jan Laws

Jan Laws is a member of the Product Management team at symplr. She holds both CPMSM and CPCS certification distinctions through NAMSS. Prior to joining CACTUS/symplr, Jan served for more than 20 years in the Medical Staff Services field. Her experience includes roles in centralized verification organizations’ operations, medical staff management in both system and single hospital organizations, and provider credentialing. Jan eagerly shares her expertise through learning experiences that enhance the positive collaboration between symplr teams and our clients. In addition to her expertise in medical staff services, Jan is a licensed professional counselor who operates a successful private practice.

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