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Provider Credentialing is an essential process that both Payers and Providers manage to ensure their clinical staff is qualified and certified to practice in their network . The healthcare provider credentialing process is a pillar of quality and risk management for the healthcare industry, it’s critical for health facilities to perform their due diligence when hiring/appointing front-line medical services providers. Credentialing is the process to verifies that a physician has the necessary education, experience, training, licensure, history, and competencies to perform specified medical procedures.

Credentialing process is required during the hiring/ appointing process and at other intervals afterward, this process follow practices established by regulatory and accreditation organizations such as the Joint Commission. Below is the list of main steps of verification in credentialing process

**Board Certification – Verify current certificate level**

**Sanction Check– Verify OIG sanction check**

**Department of Health and Human Services**

**DEA certification/registration**

**Work History – extract work history from the curriculum vitae**

**NPI Validation – query state license and Medicaid/Medicare**

Healthcare provider credentialing process is a pillar of quality and risk management for the healthcare industry, it’s critical for facilities to perform their due diligence for provider onboarding

UiPath Provider Credentialing for Healthcare