Provider credentialing and privileging is a complex, ongoing process that is essential to ensure the competence and accountability of the providers working in an organization. Although it is often confused with provider enrollment or contracting with a health insurance network, credentialing and privileging form a critical component of oversight that requires active involvement of the organization’s governance and leadership along with a strong connection to patient safety and quality improvement.

Provider credentialing and privileging is required to meet UCAOA Accreditation standards as well as other accrediting and licensing bodies. This guide will walk you through the important steps to ensure that your providers are properly credentialed and privileged for the urgent care setting. Sample forms are also included to help you get started.

NOTE: This manual is not a guide to payer contracting and credentialing.