Provider Privileging Explained: A Guide for Practice Managers to Ensure Patient Safety

For practice managers, healthcare providers, and owners, provider privileging is a critical process that ensures patient safety and maintains high standards of care. Privileging grants providers the authority to perform specific medical services within a healthcare facility, confirming they have the necessary qualifications, experience, and competence. While closely related to credentialing, privileging goes a step further by defining what a provider can do, not just who they are.

The Three Types of Privileges

Privileges are typically categorized into three main types:

1. Admitting Privileges: Allow providers to admit patients to a hospital for inpatient care.
2. Courtesy Privileges: Granted to non-affiliated providers who occasionally need to treat patients at the facility.
3. Surgical Privileges: Authorize providers to perform specific surgical procedures, often with detailed limitations based on their expertise.

Key Requirements for Privileging

To obtain privileges, providers must demonstrate their competence through:

• Education and Training: Verification of medical degrees, residencies, and specialized training.
• Licensure: A current, unrestricted medical license in the facility’s state.
• Malpractice Insurance: Proof of adequate coverage to protect both the provider and the facility.
• Clinical Experience: Case logs, surgical volumes, and peer attestations.
• Background Checks: Ensuring patient safety and ethical standards.
• Board Certification: Often required for specialized privileges.

The Privileging Process: Step-by-Step

1. Application Submission: Providers submit a detailed application for specific privileges.
2. Primary Source Verification: The facility verifies credentials directly with issuing institutions.
3. Peer Review: A committee of peers evaluates the provider’s qualifications.
4. Credentials Committee Review: Recommendations are made to the medical executive committee.
5. Medical Executive Committee Approval: Final approval is granted based on the application and reviews.
6. Ongoing Monitoring: Continuous performance reviews ensure quality care and compliance.

Why Privileging Matters

Privileging plays a vital role in:

• Patient Safety: Ensuring only qualified providers perform specific procedures.
• Quality of Care: Maintaining high standards through rigorous competency checks.
• Risk Management: Reducing legal and financial risks for healthcare facilities.
• Resource Allocation: Matching providers with the right skills to the right procedures.

Streamlining the Privileging Journey

Privileging can be complex, but expert credentialing support streamlines it – saving time and resources. From application prep to ongoing monitoring, specialists ensure a smooth process, so providers focus on patient care. Optimize your medical staff’s efficiency and enhance patient outcomes with expert guidance!