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Related Experiment Videos

Physician credentialing in managed care.

A Bloom1

  • 1Maxicare Health Plans, Inc., Los Angeles, CA.

Annals of Health Law
|December 10, 1991
PubMed
Summary
This summary is machine-generated.

Physician credentialing is crucial for managed care organizations seeking healthcare providers. Ensuring this process aligns with program goals is essential for effective healthcare delivery.

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Area of Science:

  • Healthcare Administration
  • Medical Staffing

Background:

  • Managed care organizations increasingly rely on physician credentialing.
  • The selection of healthcare providers is a critical function within managed care.

Purpose of the Study:

  • To emphasize the importance of physician credentialing in managed care.
  • To highlight the need for credentialing processes to align with managed care objectives.

Main Methods:

  • Review of managed care industry practices.
  • Analysis of credentialing process requirements.

Main Results:

  • Physician credentialing is a standard practice in managed care.
  • The effectiveness of credentialing is tied to its alignment with program goals.

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Conclusions:

  • Managed care programs must ensure their physician credentialing processes are effective.
  • Alignment between credentialing and program goals is key to successful provider selection.