Credentialing
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Credentialing
Credentialing is the process of establishing the qualifications of licensed medical professionals and assessing their background and legitimacy. Credentialing is the process of granting a designation, such as a certificate or license, by assessing an individual's knowledge, skill, or performance level. In healthcare industrCredentialingis defined as a formal process that employs a set of guidelines to ensure that patients receive the best possible care from healthcare professionals who have undergone the most stringent scrutiny regarding their ability to practice medicine. Many health care institutions and provider networks conduct their own credentialing, generally through a credentialing specialist or electronic service, with review by a credentialing committee. It may include granting and reviewing specific clinical privileges, and allied health staff membership. Insurance credentialing / medical credentialing Credentialing is the process the healthcare facility or managed ...
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National Association Medical Staff Services
The National Association Medical Staff Services (NAMSS) is an association for medical staff professionals in the United States. NAMSS was established in 1971, has over 6,000 members and is headquartered in Washington, D.C. NAMSS followed in the footsteps of the California Association of Medical Staff Services (CAMSS) which was established in 1971. Most States have active NAMSS Affiliate Organizations. NAMSS provides educational opportunities for its members and works to foster public awareness of the role of medical staff professionals in quality healthcare. Current work NAMSS members are employed by hospitals, managed care organizations, ambulatory surgery centers, physician practice groups, medical insurance carriers, HMO In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded healt ...s and ...
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Licensed
A license (or licence) is an official permission or permit to do, use, or own something (as well as the document of that permission or permit). A license is granted by a party (licensor) to another party (licensee) as an element of an agreement between those parties. In the case of a license issued by a government, the license is obtained by applying for it. In the case of a private party, it is by a specific agreement, usually in writing (such as a lease or other contract). The simplest definition is "A license is a promise not to sue," because a license usually either permits the licensed party to engage in an activity which is illegal, and subject to prosecution, without the license (e.g. fishing, driving an automobile, or operating a broadcast radio or television station), or it permits the licensed party to do something that would violate the rights of the licensing party (e.g. make copies of a copyrighted work), which, without the license, the licensed party could be ...
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Medical
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others. Medicine has been practiced since prehistoric times, and for most of this time it was an art (an area of skill and knowledge), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ...
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Professional
A professional is a member of a profession or any person who works in a specified professional activity. The term also describes the standards of education and training that prepare members of the profession with the particular knowledge and skills necessary to perform their specific role within that profession. In addition, most professionals are subject to strict codes of conduct, enshrining rigorous ethical and moral obligations. Professional standards of practice and ethics for a particular field are typically agreed upon and maintained through widely recognized professional associations, such as the IEEE. Some definitions of "professional" limit this term to those professions that serve some important aspect of public interest and the general good of society.Sullivan, William M. (2nd ed. 2005). ''Work and Integrity: The Crisis and Promise of Professionalism in America''. Jossey Bass.Gardner, Howard and Shulman, Lee S., The Professions in America Today: Crucial but Fragile. Da ...
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Guideline
A guideline is a statement by which to determine a course of action. A guideline aims to streamline particular processes according to a set routine or sound practice. Guidelines may be issued by and used by any organization (governmental or private) to make the actions of its employees or divisions more predictable, and presumably of higher quality. A guideline is similar to a rule, but are legally less binding as justified deviations are possible. List of guidelines Examples of guidelines are: * Code of practice * EASE Guidelines for Authors and Translators of Scientific Articles * Federal Sentencing Guidelines * Guidelines for Examination in the European Patent Office * Medical guidelines * Publicly Available Specification * Programming style guidelines * UNGEGN Toponymic Guidelines The United Nations Group of Experts on Geographical Names (UNGEGN) is one of the nine expert groups of the United Nations Economic and Social Council (ECOSOC) and deals with the national and ...
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Health Care
Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions all constitute health care. It includes work done in providing primary care, secondary care, and tertiary care, as well as in public health. Access to health care may vary across countries, communities, and individuals, influenced by social and economic conditions as well as health policies. Providing health care services means "the timely use of personal health services to achieve the best possible health outcomes". Factors to consider in terms of health care access include financial limitations (such as insurance coverage), geo ...
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Software
Software is a set of computer programs and associated documentation and data. This is in contrast to hardware, from which the system is built and which actually performs the work. At the lowest programming level, executable code consists of machine language instructions supported by an individual processor—typically a central processing unit (CPU) or a graphics processing unit (GPU). Machine language consists of groups of binary values signifying processor instructions that change the state of the computer from its preceding state. For example, an instruction may change the value stored in a particular storage location in the computer—an effect that is not directly observable to the user. An instruction may also invoke one of many input or output operations, for example displaying some text on a computer screen; causing state changes which should be visible to the user. The processor executes the instructions in the order they are provided, unless it is instructed ...
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Medical Credentials
Healthcare professional credentials are credentials awarded to many healthcare practitioners as a way to standardize the level of education and ability to provide care. Clinicians * Physician ** Bachelor of Medicine, Bachelor of Surgery (MBBS) ** Doctor of Medicine (M.D.) ** Doctor of Osteopathic Medicine (D.O.) * Dentist ** Bachelor of Dental Surgery (BDS) ** Doctor of Dental Medicine (DMD) ** Doctor of Dental Surgery (DDS) * Optometrist ** Doctor of Optometry (OD) * Podiatrist ** Doctor of Podiatry (DPM) * Chiropractor ** Doctor of Chiropractic (DC) * Physician Assistant (PA) ** Doctor of Medical Science (D.Med.Sc.), (D.M.Sc.) ** Master of Medical Science (M.Med.Sc), (M.M.Sc.) ** Master of Physician Assistant Studies (M.P.A.S.) ** Professional (Second-entry) Bachelor of Science in Physician Assistant (B.Sc.PA.), (B.H.Sc.PA) * Pharmacist (R.Ph.) ** Doctor of Pharmacy (PharmD) **Master of Pharmacy (MPharm) **Bachelor of Pharmacy (B.Pharm) Medical Researchers * Philosop ...
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Economic Credentialing
Economic credentialing is a term of disapproval used by the American Medical Association (AMA). The association defines the term as "the use of economic criteria unrelated to quality of care or professional competence in determining a physician's qualifications for initial or continuing hospital medical staff membership or privileges." Traditionally, physicians applied for hospital staff membership based on education, medical licensure and a record of quality care. Privileges are requests to perform certain procedures or use certain skills based on training and experience. For example, an obstetrician and a family practitioner might request privileges for both routine deliveries and caesarean sections. Typically an obstetrician could demonstrate enough experience and be granted those privileges. The FP might obtain both procedures or be restricted to routine deliveries only, or none at all, based on hospital policy. As medical costs have increased and reimbursement has decli ...
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Actuarial Credentialing And Exams
The actuarial credentialing and exam process usually requires passing a rigorous series of professional examinations, most often taking several years in total, before one can become recognized as a credentialed actuary. In some countries, such as Denmark, most study takes place in a university setting. In others, such as the U.S., most study takes place during employment through a series of examinations. In the UK, and countries based on its process, there is a hybrid university-exam structure. Policies of various countries Australia The education system in Australia is divided into three components: an exam-based curriculum; a professionalism course; and work experience. The system is governed by the Institute of Actuaries of Australia. The exam-based curriculum is in three parts. Part I relies on exemptions from an accredited under-graduate degree from either Monash University, Macquarie University, University of New South Wales, University of Melbourne, Australian National Univ ...
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License
A license (or licence) is an official permission or permit to do, use, or own something (as well as the document of that permission or permit). A license is granted by a party (licensor) to another party (licensee) as an element of an agreement between those parties. In the case of a license issued by a government, the license is obtained by applying for it. In the case of a private party, it is by a specific agreement, usually in writing (such as a lease or other contract). The simplest definition is "A license is a promise not to sue," because a license usually either permits the licensed party to engage in an activity which is illegal, and subject to prosecution, without the license (e.g. fishing, driving an automobile, or operating a broadcast radio or television station), or it permits the licensed party to do something that would violate the rights of the licensing party (e.g. make copies of a copyrighted work), which, without the license, the licensed party could be ...
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Certification
Certification is the provision by an independent body of written assurance (a certificate) that the product, service or system in question meets specific requirements. It is the formal attestation or confirmation of certain characteristics of an object, person, or organization. This confirmation is often, but not always, provided by some form of external review, education, assessment, or audit. Accreditation is a specific organization's process of certification. According to the U.S. National Council on Measurement in Education, a certification test is a credentialing test used to determine whether individuals are knowledgeable enough in a given occupational area to be labeled "competent to practice" in that area. Types One of the most common types of certification in modern society is professional certification, where a person is certified as being able to competently complete a job or task, usually by the passing of an examination and/or the completion of a program of stu ...
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