When applying for a job, there are always processes that need to be followed. And healthcare jobs are no different from them.
This is why there is a process called Healthcare Credentialing. This process is when a healthcare institution independently verifies a new hire’s education, training, work history and licenses to ensure safe patient care. This process is not the same as a license. Credentialing is done by your employer or insurance payer to evaluate if the employee meets their specific standards. Employers do not rely on the papers that applicants submit. They will contact the University, Medical Board, or the previous employer who issued the documents directly to confirm if the documents submitted are real.
There are several things that new hires need to know about how employers handle the licenses employees submit. Below are some guidelines for new hires about their licenses:
· Must have an Active and Unrestricted status- your licenses must have active, current, and must be clear of any disciplinary actions, suspension, or probation in the current state where you are practicing.
· You must provide active licenses for certifications such as BLS, ACLS, PALS, or any board Certifications
· You must track the expiration dates of your licenses, and let the HR or Medical Staff Office log your license and Certification expiry dates to set up automated renewal alerts
· Always remember that facilities query the National Practitioner Data Bank (NPDB) to check for past medical malpractice payments, adverse action, or license surrenders.
While licenses are one of the top priorities of an institution in looking for employees, they also do background checks of their employees to ensure the safety of their patients. We also have below a list of what new hires need to know about background checks that employers do:
· Criminal Background Screening- employers run state and federal criminal history checks to screen for offenses that an employee made that could have a high chance of threatening a patient’s safety
· Exclusion List Check- employers check federal and state database exclusion list to ensure that their employee is legally permitted to bill federal healthcare programs like Medicare and Meadicaid.
· Work History and Reference Gaps- employees must account for their complete employment history. Credentialing Specialists will contact past direct supervisors and inquire for any unexplained gaps in your CV.
· Many facilities require a physical health exam, drug and alcohol screening, immunizations (hepatitis B and MMR), and TB Testing before allowing a new hire to step onto the floor.
Being credentialled means that you are qualified to treat patients at a facility, but if your insurance enrollment isn’t finished, your services may not be reimbursed. That is why you need to register through CMS PECOS to have a contract with insurance companies so the facility can bill for your services.
The entire process typically takes 30 days to 6 months, depending on the response of the references contacted. So, it is much better to start early and submit all transcripts, license numbers, past employer contact info, and certification cards to prevent delayed start dates.
Lastly, always be transparent. Disclose any past problems that happened. Like, misdemeanors, light disciplinary actions, or malpractice claims upfront. Any issues discovered during verification of your papers may cause immediate rejections or termination of the onboarding process.