Using electronic provider credentialing to address the quality revolution.

Abstract

In recent years, provider credentialing has emerged as a quality initi ative for managed care organizations (MCOs). To satisfy the quality concerns of insurers, purchasers and patients, network officials are seeking industry accreditation, which requires credentialing. But while many organizations are conducting credentialing, it can be an underutilized and misunderstood resource. Credentialing is not an end in itself; it is the first step in building a quality management system. Used in this context, credentialing confers enormous advantages that go far beyond basic background checks.