Provider Data Management

The Complete Guide: How to Credential, Privilege, and Evaluate Advanced Practice Providers

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Overview

Is your organization relying on advanced practice providers (APPs) to help provide patient care? Are they appropriately credentialed and privileged? What does OPPE and FPPE look like for these vital members of your organization?

With the growing physician shortage, healthcare organizations like yours continue to rely on Advanced Practice Providers to provide patient care. The COVID-19 pandemic exacerbated the physician shortage, making APPs even more important than before, however, they are not credentialed, privileged, or evaluated the same way as physicians.

You may be wondering:

  • Are APP and physician credentialing, privileging, and evaluation the same? Are all diverse types of APPs handled the same way?
  • What are the regulations for these types of providers? Am I tracking the right quality measures that will affect reimbursement?
  • How do I update privileges as the scope of the APP role expands?

We’ve gathered insights from across the industry, including years of experience helping customers navigate provider data management, to bring you this handbook.

Handbook contents

In this handbook you'll find:

  • A breakdown of Joint Commission and CMS standards and regulations
  • A guide to handling scope expansion for non-physician providers
  • Best practices for integrating APP credentialing and enrollment
  • Guidance for ongoing and focused professional practice evaluation (OPPE/FPPE)
  • Advice for using software to manage APP data

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