Health / Health Insurance / Credentialing: The process of obtaining, reviewing, and verifying a provider's credentials?€”the documentation related to licenses, certifications, training, and other qualifications?€”for the purpose of determining whether the provider meets the MCO's preestablished criteria for participation in the network.
Search Google for Credentialing:
Health / Health Insurance / Credentialing Committee: Committee, which may be a subset of the QM committee, that oversees the credentialing process. MORE
Health / Health Insurance / Recredentialing: Reexamination by an MCO of the qualifications of a provider and verification that the provider still meets the standards for participation in the network. MORE
Health / Health Insurance / Primary Source Verification: A process through which an organization validates credentialing information from the organization that originally conferred or issued the credentialing element to the practitioner. MORE