Staffing sources describe their credentialing as automated or AI-powered. For an urgent care operator, the useful question is which parts. A credentialing file contains three kinds of work, and software does something different for each: it can finish a lookup, it can only speed up a request, and it can't make a decision.
This post explains the three kinds, what automated credentialing means for each one, and what to ask a staffing source that uses the word.
Lookups: where automated credentialing does the most
A lookup is a question with a recorded answer. Is this license active? Is this person on an exclusion list? The answer already exists, and getting it means asking the body that holds the record.
Exclusion screening is the clearest case. The HHS Office of Inspector General keeps a list of excluded individuals and entities, and the list can be searched online. Software can run that search, save the result with the date, and run it again on a schedule.
Repeating a lookup is where software helps most. A check done once at the start shows the status on that day only. Software can check again before each block of shifts, so you learn about a change in status before the shift it affects.
A lookup needs a source that allows it. Where the record holder offers no electronic access, a person still has to look it up or request it.
Reading a document isn't verifying it
Software can read an uploaded document. It can pull the license number, the name and the expiration date from a scan and fill in a form with them, which saves typing and reduces transcription mistakes.
That step describes the document. It doesn't confirm the credential. A copy of a license shows what was true when the copy was made, and it can't show a suspension or a lapse that came later. The current status comes from a lookup with the issuing board.
When a staffing source says a credential is verified, ask which of the two happened: a lookup with the issuing body, or a review of an uploaded copy. Both have a place in a file, and they don't establish the same thing.
Requests: automated credentialing can remind, but it can't answer
Some items in a file come from a person. A reference has to write back. A former employer has to confirm dates of work. Software can send the request, send a reminder, and show you that the item is still open. The reply still depends on the other person.
Some records can only come from the clinician. The National Practitioner Data Bank holds malpractice payment and adverse action reports, and a practitioner can order a self-query and receive a certified PDF of any matching reports. The NPDB doesn't send that response to third parties. If your clinic asks for a self-query, the clinician has to order it and share it, and no software can do that part for them.
For requests, the benefit of software is status. You can see which item a file is waiting on and who has to act, so you chase one person and not the whole file.
Decisions: the part of credentialing that stays with your clinic
The last kind of work is judgment. Does a past board action rule a clinician out? Is a gap in work history explained well enough? Which certifications do you require for an RN, and which for a PA?
Software can apply a rule you've written, such as "send any file with a board action to the medical director." It can't decide what your clinic accepts. Your clinic is responsible for who works there, and that stays true whichever staffing source assembled the file.
The work that shortens this step is yours. Write your criteria for each role and name the person who approves a file. The operator's guide to urgent care locum credentialing lists what a written policy should say and which checks apply to which clinician type.
Questions to ask about automated credentialing
Ask a staffing source these before you rely on its file:
- For each check, is it a lookup with the record holder or a review of an uploaded document?
- What date did each check run, and is it repeated?
- Which items depend on a reply from a person, and can I see which ones are still open?
- When a check finds something, who reviews it, and am I told?
- Can I see the file before the shift?
- Which checks should my clinic still run itself?
Keep running the exclusion search yourself. Anyone who hires a person on the OIG list may be subject to civil monetary penalties, so keep your own dated record for every role, clinical or not.
This is general information about how credentialing works. It isn't legal advice. State law, your payer contracts and any accreditation your clinic holds set the rules you're held to, so check yours with your attorney or compliance lead.
What this means for clinicians
If you're the clinician, the split tells you where your effort counts. Lookups need nothing from you beyond accurate license details. Requests go faster when your references know to expect them. Your first locum tenens assignment lists the documents to have ready.
Credentialing on Rediworks
On Rediworks, clinicians upload their documents once to a credential wallet. Their licenses and documents are reviewed, and exclusion screening runs automatically. The status of each check shows in the dashboard. Your clinic sees who applied and decides who works the shift.
Signup is self-service, with no demo and no sales call. Sign up to post shifts.