Clinician guides

Credentialing checks a clinician’s qualifications, privileging authorizes specific patient care services, and payer enrollment applies for inclusion in insurance panels so the clinician can bill and be paid. These are separate processes for physicians, NPs and PAs starting a job, not interchangeable steps.

The Interstate Medical Licensure Compact is a voluntary expedited pathway for qualified physicians to obtain separate licenses from participating state boards. It requires a qualifying State of Principal License and Letter of Qualification and does not cover NPs or PAs.

Before adding a physician license, decide whether the Compact fits your eligibility and gather the qualification records that boards and employers commonly verify. Requirements differ by state, so confirm each medical board’s requirements, fees and renewal dates yourself.

Before accepting a physician job, settle who handles credentialing, privileging and payer enrollment and what the realistic first patient day will be. Ask about the information submitted for you, malpractice and tail coverage, and the license, DEA and CME support your role requires.

NPs and PAs should ask separately about credentialing, privileging and payer enrollment, the first patient day, and malpractice and tail coverage before accepting a job. Confirm scope and supervision or collaboration requirements with your state board, and PA-C holders should plan for NCCPA certification maintenance.

Tail insurance is stopgap coverage for physicians leaving an employer’s claims-made medical liability policy, including residents leaving training-program coverage. It helps cover a later patient claim about an incident that happened while the physician was insured under that policy.

The MATE Act created a one-time, eight-hour training requirement on treating and managing patients with opioid or other substance use disorders for DEA-registered practitioners, except veterinarians. Beginning June 27, 2023, practitioners must attest to completion when submitting an initial DEA registration or renewal.

NCCPA certification maintenance is a 10-year process with five two-year cycles, each requiring 100 logged CME credits with at least 50 Category 1 credits. Log credits online and pay the maintenance fee by 11:59 p.m. PT on December 31 of your certification expiration year, checking NCCPA for the current fee.