What is the Credentialing Process for Nurse Practitioners

Written by Researchbite | Updated on: February 18, 2023

What is the Credentialing Process for Nurse Practitioners

When a provider is granted privileges, the agency certifies that they are qualified to execute a particular set of care services. It is helpful first to consider the origins of such restrictions and then to look at how laws, rules, agency policies, and joint law impact whether or not a nurse practitioner (NP) is permitted to operate in a particular location and under what circumstances.


Credentialing is typically thought of as a procedure exclusive to physicians. In actuality, obtaining credentials is crucial for all practitioners involved in patient care, including nurses. A certified nurse can take advantage of several advantages. They can endeavor to advance their careers through acknowledged accomplishments and support their professional development.

Meaning Of Nurse Credentialing

As described, the nurse credentialing procedure entails confirming the credentials and certificates of prospective nurses. This involves, among many other things, reference checks and verification of board-earned certificates, licenses, and educational credentials. This is typically done to ensure that a nurse or doctor is qualified to treat patients. A nurse must furthermore have credentials for a hospital or practice to submit a claim to an insurance provider or governmental body.

The Procedure for Obtaining Nurse Practitioner Credentials

A healthcare certification is an official endorsement to do a task lawfully or competently. You earn this when you pass your "boards" or certification exam for nurse practitioners. Credentialing is a mechanism that many companies and agencies (like Medicare and Blue Cross) utilize to make sure that the medical professionals who work for them are fully licensed and satisfy all other standards. The type of provider and specialty-specific credentials are pretty particular. Verification of education, licensure, certification and references are all parts of the credentialing process. To file claims to the government and insurance companies, a nurse practitioner or physician assistant must possess the necessary certifications.

The following steps are included in the nurse practitioner certification process:

  • First, choose a certifying body and apply.
  • Then, send the necessary details for verification.
  • Finally, take part in the examination.
  • Obtain legal authorization
  • To apply for nurse licensing, visit the state board of nursing.
  • Be patient in receiving your board of nursing license.
  • Obtain a controlled hazardous drug certificate and a DEA registration.
  •  Apply for an NPI number

The applicant or the nurse's employer is responsible for ensuring the accuracy and completeness of the information provided for verification. Any incomplete or incorrect information included in the application might lead to its rejection. Nurse practitioners can only be paid for their services once the credentialing procedure is finished. There is a lot of documentation involved in the initial credentialing process. A practice manager will often guide you through the procedure. Forms defining the standard operating procedures and protocols the provider must follow or do, license verification, a copy of the DEA certificate, professional references, and other items are typical credentialing materials.

All required documentation must be gathered and submitted to each institution or agency by nurse practitioners (or their adoring office managers).NPS can begin working when their qualifications have been confirmed, and a background investigation has been finished. Some hospitals or clinics may require nurse practitioners and physician assistants to complete a probationary term with chart reviews or other onboarding training integrated into the credentialing process. Be aware that a credentialing procedure is required when you begin a new nurse practitioner employment. The onset of action might take a month, two months, or even longer. Your first payment will arrive on schedule if you complete the relevant papers carefully, have your license and other credentials in order, and assist in speeding up the process.

Duration of the Credentialing Process for New Nurse Practitioners

The procedure of obtaining credentials might take two to three weeks. It may take time for employers to get primary source verification for every nurse practitioner currently employed. The agonizingly drawn-out procedure can cause reimbursements to be delayed and possibly stall the hiring of a much-needed nurse. It is best to delegate the process to a reputable third-party credentialing service provider.

Benefits of Working as a Nurse Practitioner

A Positive Outlook for Employment

Being a nurse practitioner has several benefits, including job stability. The fact that there is a physician shortage, people are living longer, and NPs can deliver high-quality care influences your job security. In essence, this indicates that you will be in great demand. As a result, the employment outlook for nurse practitioners is expected to increase by 28% by 2028.

Having Flexible Working Hours

The rotational schedules of a nurse practitioner may not be advantageous to certain persons but may be advantageous to others. For example, working 12-hour days with alternating shifts occasionally may result in additional time off.

Competitive Pay

Another advantage of being an NP is the competitive pay scale. You may earn a good income as a nurse practitioner and enjoy many of the amenities you've wanted. Your pay will change based on the environment you work in.

Possibility of Specialization

You have the option to focus on a field that you are enthusiastic about as a nurse practitioner. As a result, not only will you become an expert in your profession, but you can also get the chance to participate in research and other initiatives on a topic that you are passionate about.

Possessing a Demanding Profession

You'll discover that working as a nurse practitioner means that every day will be unique. You will constantly be learning and using what you have learned in the conditions you face daily. You will learn essential lessons from these interactions that you may use in future situations. Said, you won't ever get bored.

Development of Telehealth

With this worldwide epidemic, telehealth has advanced to the forefront of medicine. You can be asked to perform telehealth sessions with patients as a nurse practitioner.

Drawbacks to Working as a Nurse Practitioner

Protracted Educational Route

The training required to become a nurse practitioner spans several years. You must first obtain a nursing bachelor's degree to begin the route to becoming an NP. After that, you'll need to continue your studies and get your master's or doctorate in nursing.

Working while enrolled in NP School

You might be unable to keep working a full-time job if the NP educational program you choose to enroll in is too demanding. While some programs are less demanding and let you work both full- and part-time, others are more demanding and demand that you commit to a full-time study schedule. Some people might not be able to pull off a situation like this.

To practice, you must pass a certification test

To become a nurse practitioner, you must successfully complete a national certification test.

The Fluctuation in Working Hours

Depending on the environment in which you choose to work, you could not follow the conventional Monday through Friday, 9 to 5 schedule. It is conceivable to have a timetable like that. However, there are also different schedules. There will be an average of 40 hours of labor each week. You can find yourself working evenings, weekends, and days that are 10 to 12 hours long. These long shifts may negatively impact some people's social and personal lives.

Workplace Circumstances

Being an NP may have specific challenges, another drawback for some people. You can be exposed to poisons and infections if you decide to work in a medical facility. This may place your health in danger.

Workplace Stress

Any profession you choose to work in might stress you out. You could experience a lot of difficult circumstances in your career as a nurse practitioner. This stress may result from your job's surroundings, like a critical care unit, or it may be brought on by the knowledge that you are in charge of a patient's treatment strategy.

Displaying Nursing Credentials

The following is the recommended sequence for displaying the credentials:

  1. Degrees: The highest degree achieved is listed first, including doctorate degrees (Ph.D. and DNP), master's degrees (MSN), bachelor's degrees (BSN), and associate's degrees (ASN) (ASN).
  2. License: An RN or LPN must possess the appropriate license to practice nursing.State designation or mandate: Family nurse practitioner (FNP), advanced practice registered nurse (APRN), and nurse educator (NE).
  3. National qualification: The Family Nurse Practitioner-Board Certified credential is given by an accrediting authority (such as the ANCC) (FNP-BC)
  4. Honors and awards: Distinguished performance awards, such as Fellow of the American Academy of Nursing.
  5. Non-nursing certificates that recognize extra talents are among the other credentials.


To practice, keep privileges, and submit for payment, every healthcare practitioner within a healthcare delivery organization has to be credentialed initially and then renewed every three years. The medical staff services team or an independent credentials verification organization (CVO) handles the credentialing procedure when a healthcare company recruits licensed and certified nurse practitioners. Healthcare organizations validate clinicians' education, training, certificates, and licenses through credentialing. Additionally, they look for any penalties or disciplinary measures taken against the supplier. To effectively follow the credentialing requirements for each medical staff member, a medical staff services department must be conversant with hundreds of healthcare taxonomies. There are more than 183 distinct certifications available in nursing alone.


  • https://www.npjournal.org/article/S1555-4155(19)31014-1/pdf
  • https://onlinenursing.duq.edu/blog/benefits-of-nursing-certification/



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