Must a PA-C Be Credentialed with Medical Networks?

There is no way around this, you must be credentialed when seeing members (patients) of a medical network. Why? We understand you are supervised and so you wonder why all the bother? Why go through the same process as the supervising MD?

Well, this is a simple answer. Anyone who has contact with network members (patients) will need to undergo a thorough check of their credentials. The network must check out who you are and confirm everything from education to affiliations, boards, and licenses. They also need to do monthly monitoring to remain compliant with OIG.

What is the OIG?
Office of Inspector General (United States)
In the United States, the Office of Inspector General (OIG) is a generic term for the oversight division of a federal or state agency aimed at preventing inefficient or illegal operations within their parent agency.
*Reference: https://en.wikipedia.org/wiki/Office_of_Inspector_General_(United_States)

How does one remain OIG Compliant and what organizations are included under OIG?
OIG includes the following federal organizations: OIG, GSA, DEA, FDA, PHS, ORI, TRICARE and OFAC-SDN data (federal only) and Medicare Opt-Out.

These checks and balances are the Federal Government’s minimum requirements and allows us to check if a provider has made their exclusion list. This type of monitoring must be completed monthly on all providers within the medical network. But networks are the only ones who are required to do monthly monitoring. Your local Urgent Care, Hospitals, Surgery Centers, and others too must abide by this Federal Government’s Medicare rule.

So yes, you must go through the credentialing process when joining a medical network.

Patient care and safety comes first.