Medical credentialing and hospital privileging are both pertinent processes for physicians and other medical staff that ensure the quality care of patients and proper delivery of medical treatment from qualified practitioners.
So as not to confuse the two, medical credentialing, aka healthcare credentialing, must occur before a physician’s hospital privileges can be granted. Both are complicated and lengthy processes, and if done incorrectly can lead to costly liabilities as well as downgrading a hospital or practitioner’s reputation and rating.
What are hospital privileges?
Hospital privileges authorize medical practitioners for a specific practice of patient care in a specified healthcare facility. Privileges are granted to physicians based on their current medical credentials and previous performance.
Types of hospital privileges:
- Admitting privilege: authorizes physicians to admit patients into specific hospitals or medical centers.
- Courtesy privilege: authorizes physicians to occasionally treat or admit patients into specific hospitals.
- Surgical privileges: authorizes physicians to perform outpatient or operating room surgeries.
Why do physicians need hospital privileges?
In order for a physician to perform specific procedures at a specific hospital, they must apply for privileges. Appointment and re-appointment for hospital privileges costs providers vast amounts of time and attention but are an essential component to high-quality healthcare and patient safety. If physicians don’t have hospital privileges, they can’t provide services to patients.
Who awards physicians their privileges?
The Joint Commission and Medicare hold hospitals responsible for granting privileges to their physicians. This means hospitals take full responsibility for awarding appropriate privileges, which means if the physician is not granted privileges, they cannot practice in that hospital. Whether or not a physician receives hospital privileges is decided by a committee of the hospital’s medical staff.
How physicians obtain hospital privileges
In order for physicians to receive privileges, they must complete and submit an application to that hospital. This process can be quite tedious and complicated as it requires extensive information, forms, and paperwork to be completed correctly.
- Before you apply for privileges at a specific healthcare facility, you should check the medical staff bylaws to make sure you meet their eligibility criteria.
- A hospital’s medical staff bylaws establish the rights, responsibilities, and accountability of all practicing medical staff. They also set out the organization and structure of each hospital.
- In order to award privileges, the hospital will review a physician’s credentials. This means the medical credentialing process must be completed before the hospital privileges process can begin. Credentials review a physicians’ education, residencies, fellowships, board certifications, and practice experience.
How do hospitals determine a physician’s competency for hospital privileges?
Set out by the Accreditation Council for Graduate Medical Education (ACGME) and American Board of Medical Specialties (ABMS), the following areas provide a framework to determine a physician’s competency for hospital privileges:
- Patient care
- Medical clinical knowledge
- Practice-based learning and improvement
- Interpersonal and communication skills
- System-based practice
How long do hospital privileges last once they’re obtained?
According to The Joint Commission, hospital privileges for physicians need to be renewed every two years (except for Illinois, which requires every three years).
How can physicians make the process of obtaining hospital privileges easier?
Physicians can spend enormous amounts of time and energy filling out piles of paperwork and applications and gathering all of the correct and complete information to obtain their hospital privileges. With plenty of room for error and mistakes to occur along the way, the credentialing application process has great potential to be delayed. Plus, when mistakes are made, physicians and hospitals run the risk of delivering practices they’re not licensed to perform which can then lead to costly liabilities and diminished reputations.
Med Advantage offers Provider Enrollment Services that take care of the time-consuming credentialing work for physicians, hospitals, and medical practices. As an affordable outsourcing solution with flexible plans tailor-made for offices with one provider or facilities and organizations with hundreds of providers, our services make the privileging process easy, fast, and stress-free.