Mistakes 300x300 | Top 5 Medical Licensing Mistakes | STATMedCare Payor and Physician Enrollment and Credentialing

The process of obtaining a medical license, either initial licensure or a second or subsequent license in another state, can be a challenging and lengthy process.

Many states have expanded what is considered to be the practice of medicine to address new trends in the medical field that need to be regulated by medical boards. For example, a number of states have passed legislation in recent years that empower medical boards to have jurisdiction over the practice of medicine across state boundaries or treatment decisions made by Medical Directors of Managed Care Organizations.

A physician seeking initial licensure, or subsequently applying for a license in other states, should anticipate the possibility of delays due to the necessary investigation of credentials and past practice, as well as the need to comply with necessary licensing standards. To assist a physician in the quest for licensure, the following are five (5) common mistakes providers make when applying for a medical license:

1. Licensure Requirements: You must always confirm the current licensing requirements before starting the application process. The state board rules and regulations change frequently and, therefore, you must confirm if you are eligible to apply for a license before even starting the process.

2. Disclosure of all information: You should never try to hide negative information from a licensing board. It is much better to come forward with the information, assist the board in obtaining records and other necessary data, and provide information about mitigating circumstances that would prevent license denial. Full and frank disclosure of all information requested is by far the best approach to successful licensure. A physician should remember that, in most states, making a false statement on an application for licensure is grounds for denial or future restriction. You must answer all questions on the application and for those that are marked with a “yes” you must provide explanations and be forthright.

3. Third Party Verifications: When applying for a medical license, every state board requires primary source verification of your education, training, boards, other state licenses, etcetera. The following are some common mistakes when it comes to third party verifications:

• Information is not listed correctly on the application.
• Dates are not listed correctly and do not match the provider’s certificates.
• Dates are not listed in the required MM/YY format.
• Every single license ever held is not listed.
• Primary source verification is not ordered for each license regardless if the license is active/inactive.
• All required third party verifications are not requested.
• Follow up on each request – to ensure everything is being processed and sent directly to the board – is not done.

4. FCVS: If FCVS is required by a licensing board (some boards make this a mandatory requirement) and the FCVS application isn’t completed correctly, there will be a delay in the processing of your application.

5. Follow-up: Following up with the licensing boards in other states where the physician holds, or has held, a license may assist you in shortening the timeframe for licensure. It is important to note a difference between follow-up and excessive use of phone contact. Excessive use of phone contact often delays the processing of requested verification materials since the physician’s application, or request, may need to be pulled from the “stack” to answer an inquiry. A short note to the organization processing the request, asking for information 30 days after the initial letter or form was mailed, may be a better course to follow than frequent phone contact.

If you would like assistance with licensing, contract negotiation, payor enrollment or credentialing, please contact us.

Cynthia Young is the CEO of STAT MedCare Solutions, a U.S.-based, national provider of credentialing, payor enrollment, rate negotiation and other credentialing related services.