Final answer:
Physician credentialing is the process of evaluating and verifying their qualifications. Hospitals, rehabilitation centers, and long-term care facilities also go through a similar process. Credentialing affects payer-provider contracts by determining which providers can participate in insurance networks.
Step-by-step explanation:
Physician credentialing is the process by which physicians are evaluated and verified for their qualifications and abilities to provide medical care. The initial application includes submitting documentation such as medical licenses, education, and references. If denied, physicians can appeal the decision by providing additional supporting evidence.
Hospital, rehabilitation centers, and long-term care facilities also go through a credentialing process to ensure they meet certain standards and qualifications. This includes evaluating the facility's policies, procedures, staffing, and ability to provide quality care.
Credentialing affects payer-provider contracts by determining which healthcare providers are eligible to participate in insurance networks. Insurance companies often require providers to be credentialed to be included in their network and receive reimbursement for services rendered.