Telehealth Provider Management Strategy: Expanding the Adoption of Credentialing by Proxy

June 23, 2022 Chris Malanuk, SVP, Governance & Provider Solutions

It is well known any provider must be properly credentialed to practice medicine – inclusive of all telehealth providers, too. In the telehealth setting, credentialing by proxy allows hospitals to rely on the credentialing practices of another entity (provided the entity follows a fully accredited and reviewed credentialing process as prescribed by CMS), thus providing additional flexibility for the provider, the health system, and ultimately – the patient.

Prime Health Systems for a Credentialing by Proxy Model

Referral Centers. Credentialing by proxy is especially useful for hospitals who have a subset of providers engaging in telehealth services. Hospitals who act as referral centers are uniquely positioned to benefit from a credentialing system that includes advanced tools to support credentialing by proxy with the presentation of profiles for access and consideration by the originating site.  As the entire process is already governed in accordance with CMS or related accreditation processes such as TJC, providers can be assigned to a telehealth category which can subsequently be leveraged to provide access for the originating sites to see maintained profiles on the providers and offer direct assurance to solve for compliance concerns. This design allows originating site entities to rest assured they do not need to process a separate application nor solely rely on a roster as an addendum to a contract, but rather have direct access to confirm the expected file management practices are in place.  Critical Access Hospitals having the ability to rely on the credentialing process of distant telehealth sites through credentialing by proxy also supports the expansion of community health efforts by expanding access to care, especially in rural areas.

Exclusive Telehealth Providers. The explosive growth of telehealth providers during the pandemic has caused many health systems who exclusively provide telehealth services to turn to credentialing by proxy to ensure they have well-managed and high-quality providers, even when working in an entirely remote environment. This approach removes the need to credential providers at each originating site client, thus saving time and reducing administrative burdens. Credentialing by proxy can be a contractual requirement for specialty services. This model can provide health systems with an efficient approach to provider management efforts that leverages external resources and expertise on credentialing services.

4 Reasons to Adopt Credentialing by Proxy in Your Organization:

  1. Better, Safer Patient Experience. Increase access to care where patients live and work, in turn improving both clinical outcomes and patient satisfaction. Enable health systems to provide access on a more expedited, efficient, and cost-effective basis than traditional credentialing, but with the full transparency of a well-structured credentialing process 


  1. Faster Implementation. Provide acute telemedicine sooner, allowing you to meet clinical and financial objectives. Reduce long wait times and redundant efforts with a process that can often be completed in one month. 


  1. Reduced Costs and Administrative Burdens. Benefit from a cost-effective alternative to traditional credentialing while also efficiently expanding your virtual care program without overburdening your in-house staff. 


  1. Enhanced Access to Virtual Providers. Obtain required medical competence in a timely and efficient manner. Gain access to the highest quality virtual providers while needed. 


If the credentialing by proxy model is more widely adopted, it would allow health systems to leverage the technology of credentialing solutions and allow limited view access to provider data, further improving general confidence in the proxy arrangement. Increasing the effectiveness of telemedicine applications saves both time and money – all while providing patients with expanded and expedited services, leading to overall safer care.






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