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Lesson 11: Licensing, Credentialing and Privileges

Stay legal and official

The key to streamlining the licensing, credentialing and privileging process is making sure you have key documents on hand, ready to be sent.  If it seems redundant, it is.  But that’s the reality of the process and being prepared is your best strategy.

Licensing

The Uniform Application for Physician State Licensure (UA) standardizes, simplifies and streamlines the licensure application process for physicians. Just fill out the UA online application once, then use it whenever you apply for licensure in another state that accepts or requires the UA for the rest of your career.

The process of obtaining a medical license—either initial licensure or a second or subsequent license in another state—can be very challenging. To help navigate the licensure process and provide up-to-date information on licensure requirements around the country, the AMA publishes the State Medical Licensure Requirements and Statistics.

Credentialing

Credentialing for hospital privileges can take a long time.  Your health plan credentialing depends on your privileges, so you must start the process early.

Learn as much as you can about hospital credentialing before you begin, to make the process easier.

Privileges

Once approved, the committee appoints the physician to the medical staff for one year on the initial appointment and every two years after that.

Privileges can be denied if doctors don’t have enough training and/or can’t show they are competent, lose their medical licenses in other states, are excluded from Medicare or Medicaid or have previously been found guilty of fraud or abuse. 

Privileges can be suspended if a physician does not perform enough of the specified procedure or treat enough of a patient type to stay proficient.

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