Road Blocks in Credentialing
                     Road 
Blocks 
In 
Credentiali
ng
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Intoduction
 Physician Credentialing Service is a cumbersome 
process which requires us to gather a large amount 
of information regarding a healthcare professional 
with a holistic approach to deduce the authenticity 
of the information prior to submitting it to the 
concerned parties for processing. 
 An efficient Credentialing process will shed light on 
a variety of underlying items about a healthcare 
professional’s history.
 This would aid us in revealing a pattern and help us 
in identifying the root cause of some disruptions 
like, when they provide us with inadequate 
expertise to perform their basic responsibilities and 
provide contradicting evidence which leaves us 
stranded when trying to correlate the authenticity 
of their professional competence.
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Listed below are some road blocks to be vigilant while 
credentialing any healthcare professional.
 Questionable breaks in Work History and reluctant 
to provide previous employers or organizations 
contact information for verification.
 Failure to provide functional peer references or 
peer references revealing contradicting information 
upon establishing contact regarding the applicant.
 Failure to provide adequate quality of care to 
members and unprofessional conduct which led to 
frequent resignations & short tenures at various 
Healthcare Organizations.
 Failure to provide full disclosure regarding any 
adverse actions, pending sanctions or revocation 
placed on their State Licenses/Board Certifications.
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 Inconceivable level of timeframe consumed to 
complete the obligatory trainings and corrective 
actions required by the state licensing body to re-
claim their licensing privileges.
 Furnishing irrelevant training or proficiencies 
corresponding to the privileges applied which  led 
to withdrawal of Hospital Privileges and affiliation.
 Malpractice Insurance coverage from numerous 
agencies with inadequate coverage amounts and 
multiple gaps in coverage and not disclosing 
pending lawsuits voluntarily.
 Remarkably high number of malpractice lawsuits, 
actions and judgments filed against the Healthcare 
professional which reveals their level of 
professional conduct or potential deficiency.
ABOUT US
e-care’s Credentialing team 
vigilantly follows an eye for 
detailed approach so that a 
healthcare professional meets 
all the criteria as required by the 
Payer or Healthcare 
Organization by reviewing the 
items such as the individual’s 
license, experience, 
certification, education, training, 
affiliations, malpractice & 
adverse clinical occurrences and 
clinical judgment and bypass all 
the road Blocks that could result 
in interruption of the 
credentialing process.
THANKS
Do you have any questions?
[email protected]
+1 813 666 0028
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