Credentialing

Credentialing
Name
Institution
Credentialing
Credentialing is the verification of the qualifications of a medical practitioner for ascertaining current competence. This process involves the review of the education, experience, training, and the licensure allowing one to provide services (Cromwell, 2009).
Figure: Credentialing Process
Application
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Verification and info gathering
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493395330200Analysis

Decision
The first step involves application where then provider or practitioner is identified and undergoes prescreening to ascertain the initial qualifications. One is allowed to complete application before returning to the processing organization. The information gathering step involves developing a credential file to enable the collection of data. In the analysis is where the information file is reviewed for determination before a decision is made on qualification. It involves monitoring and the evaluation of the applicant.
Credentials Verification Organization (CVO) is an organization which comes in as a third party to gather the information of the healthcare practitioners including doctors and verifies such credentials (Hernandez, 2011). It does its work on behalf of the healthcare entities such as hospitals that offer health services. On the other hand, the National Practitioner Data Bank (NPDB) as a body plays the role of combating any form of fraud and abuse happening in the delivery of healthcare services as well as the insurance for healthcare coverage (Waters et al, 2003).

Once such acts are uncovered, there are adverse actions the body takes against the practitioners and the providers.
In any case, credentialing is advantageous especially to the consumers in that they can know those practitioners who have the right qualifications to handle their medical problems. Some problems may be complicated and require a doctor specialist in a given area which they can tell through credentialing. Also, it ensures that only those mandated with the rights tools can offer quality medical services that are advantageous to consumers (Needleman, 2014). The consumers as well as save money that may otherwise go into waste spending on the doctors not qualified.
References
Cromwell, F. S. (2009). Accreditation, certification, licensure, registration. American Journal of Occupational Therapy, 27, 307-308.
Hernandez, A. M. (2011). Trends in health care practitioner credentialing. Journal of health care finance, 24(3), 66-70.
Needleman, J., Dittus, R. S., Pittman, P., Spetz, J., & Newhouse, R. (2014). Nurse credentialing research frameworks and perspectives for assessing a research agenda. Institute of Medicine of the National Academies.
Waters, T. M., Studdert, D. M., Brennan, T. A., Thomas, E. J., Almagor, O., Mancewicz, M., & Budetti, P. P. (2003). Impact of the National Practitioner Data Bank on resolution of malpractice claims. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 40(3), 283-294.