How New Doctors Can Start Seeing Patients Before Credentialing is Complete

For newly graduated physicians or those transitioning to new practices, the credentialing process presents a significant challenge. The lengthy credentialing process can delay the start of patient care, but there are several strategies that can help new providers begin seeing patients sooner.

Understanding the Credentialing Process

Credentialing is the process of verifying a provider's qualifications, including education, training, licensure, and experience. This process typically takes 90-120 days and involves multiple steps with various payers and organizations.

Strategies for Early Patient Care

Several approaches can help new providers start seeing patients before full credentialing is complete:

1. Provisional Credentialing

Many organizations offer provisional or temporary credentialing:

Allows limited practice while full credentialing is pending
Requires completion of initial verification steps
May have restrictions on patient types or services
Typically valid for 60-90 days

2. Supervised Practice Arrangements

Working under supervision can enable early patient care:

Practice under a credentialed provider's supervision
Allows hands-on experience while credentialing is pending
Provides learning opportunities and mentorship
May require specific documentation and oversight

3. Cash-Pay and Self-Pay Patients

Focusing on self-pay patients can provide immediate practice opportunities:

No insurance credentialing required
Direct payment from patients
Simplified billing processes
Opportunity to build patient base

State-Specific Options

Some states offer specific programs for new providers:

1. Temporary Licensure

Some states offer temporary medical licenses
Allows practice while full licensure is pending
May have specific requirements and restrictions
Typically valid for 90-180 days

2. Training Licenses

Special licenses for recent graduates
Allow supervised practice
May have specific practice limitations
Require completion of certain requirements

Hospital and Health System Options

Large healthcare organizations may offer special programs:

1. New Provider Programs

Structured programs for new providers
May include accelerated credentialing
Provide mentorship and support
Offer gradual practice expansion

2. Academic Affiliations

Teaching hospital affiliations
May allow practice under academic credentials
Provide research and teaching opportunities
Offer unique practice arrangements

Billing and Reimbursement Considerations

Understanding billing options is crucial for early practice:

1. Cash-Pay Billing

Direct patient billing
Simplified documentation requirements
Immediate payment collection
No insurance claim processing

2. Supervised Billing

Billing under supervising provider's credentials
May require specific documentation
Shared revenue arrangements
Compliance with supervision requirements

Legal and Compliance Considerations

Several legal and compliance issues must be addressed:

1. Malpractice Insurance

Ensure adequate coverage for practice activities
May require specific policy endorsements
Consider tail coverage for future claims
Verify coverage for all practice settings

2. State Regulations

Comply with state practice act requirements
Understand supervision requirements
Follow documentation standards
Maintain appropriate licensure

Building Your Practice

Early practice opportunities can help build your patient base:

1. Patient Acquisition

Focus on quality care and patient satisfaction
Build relationships with referring providers
Develop strong communication skills
Create positive patient experiences

2. Professional Development

Continue learning and skill development
Seek mentorship opportunities
Participate in professional organizations
Build professional networks

Best Practices

Research state-specific options early
Maintain all required documentation
Follow all legal and compliance requirements
Focus on quality patient care
Build strong professional relationships
Plan for full credentialing completion