Delegated credentialing
Definition
Delegated credentialing is when a health plan lets a large provider group or health system credential its own clinicians, under the plan's standards and oversight, instead of the plan doing it. These delegated groups usually send rosters to the plan.
By the Candor Health team
Last reviewed
Also called delegated groups and delegated entity
Why do plans delegate?
Large groups already credential their clinicians for their own purposes. Delegation avoids doing the same work twice and speeds up adding new clinicians to the network.
What does the plan still do?
It audits the delegated group, sets the standards and stays accountable for the result.
What does it mean for provider data?
Delegated groups send rosters, often in their own formats and on their own schedules, which the plan must load and check. Roster quality from delegated groups is a common source of directory errors.