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UNIVERSITY OF CALIFORNIA DAVIS Standardized Procedures/Protocol Request for privileging for Advanced Practice Providers*For New employees: This form should accompany your full credentialing applicationName:Date:Department:Core
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How to fill out credentialing and privileging

01
Gather all necessary documentation, including your educational degrees, certifications, and licenses.
02
Complete the credentialing and privileging application form provided by the organization or institution.
03
Provide detailed information about your past work experiences, including dates, responsibilities, and reference contacts.
04
Submit any supporting documents requested, such as clinical case studies or publications.
05
Ensure all documents are properly signed, dated, and notarized if necessary.
06
Follow any specific instructions or guidelines provided by the credentialing and privileging board.
07
Pay any required fees or submit payment information, if applicable.
08
Double-check the application for accuracy and completeness before submitting it.
09
Submit the completed application and all supporting documents to the credentialing and privileging board.
10
Monitor the progress of your application and respond promptly to any requests for additional information or documentation.

Who needs credentialing and privileging?

01
Healthcare professionals, such as doctors, nurses, dentists, and therapists, who wish to work in hospitals, clinics, or healthcare organizations.
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Medical students or graduates who plan to undergo residency or fellowship programs.
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Medical staff or practitioners seeking to join a medical group or practice.
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Providers applying for insurance panel participation or network enrollment.
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Locum tenens or temporary healthcare professionals.
06
Individuals seeking medical staff privileges at a specific healthcare facility.

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Credentialing is the process of verifying the qualifications and professional history of a healthcare provider, while privileging is the process of granting specific rights or privileges to that provider to perform certain procedures or services based on their qualifications.
Healthcare providers, including physicians, nurses, and allied health professionals, are typically required to undergo credentialing and privileging to ensure they are qualified to provide care.
To fill out credentialing and privileging forms, one must provide accurate and complete information regarding their education, training, work history, licenses, and any other relevant credentials, along with required documents such as proof of certifications.
The purpose of credentialing and privileging is to ensure that healthcare providers meet established standards of care and are qualified to perform medical procedures, thereby ensuring patient safety and quality of care.
Information that must be reported includes the provider's identity, education, training, board certifications, work history, licenses, malpractice history, and any disciplinary actions.
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