Credentialing by Proxy and Telemedicine in 2021 and Beyond

Director of Credentialing Programs

Many healthcare organizations adopted telemedicine for the first time during COVID-19, introducing a wave of process changes. Assessing healthcare providers’ competencies and licenses without meeting them in person was new to many, but a wider adoption of credentialing by proxy makes the process more accessible.

Many healthcare systems pivoted to telemedicine to keep seeing patients during the pandemic. “It's more common now, especially with all the different waivers in place allowing organizations to take advantage of the services without having to jump through hoops,” says Frances Ponsioen, Senior Consultant and Senior Director of the Credence Business Unit at The Greeley Company. But organizations adopting telemedicine for the long-term will need to prepare for the expiration of waivers related to COVID-19 and establish an infrastructure for credentialing by proxy.

Here’s how to prepare your organization for credentialing providers by proxy so you can continue to offer telehealth services moving forward.

Write Credentialing by Proxy into Your Governing Documents

The first step to adopting a long-term telemedicine option is to review your governing documents and include language allowing credentialing by proxy for telemedicine services. “Ensure that all of your governance documents, bylaws, policies, and procedures are all set up to allow for and recognize telemedicine services, and specifically credentialing by proxy,” Ponsioen says. Medical staff services and the governing board must approve areas where you will use telemedicine, and you must update the language of the governing documents to reflect this approval.

Don’t wait for the COVID-19 state of emergency waivers to expire before establishing necessary agreements with the distance site where the telemedicine provider is located. Put all of the elements in place now, Ponsioen says, so you can continue offering telemedicine without any lapses in service.

Develop a Telemedicine Provider Credentialing Policy

Once you’ve written the option for telemedicine and credentialing by proxy into your governing documents, it’s time to outline policies for when credentialing by proxy will be used. Consider developing a separate credentialing policy specifically for telemedicine providers, Ponsioen suggests. Develop options based on patient demand, the number of licenses to confirm, or the number of providers you’re privileging.

If you’re only credentialing one physician, for example, you may choose to use traditional processes. If you’re credentialing a dozen providers, on the other hand, you can use credentialing by proxy to save time and free up your medical staff services bandwidth. Or, if a provider is licensed in all 50 states, your policy could give you the option to credential that provider by proxy to speed up the credentialing process and meet patient demands. 

Develop an Agreement With the Distance Site

Once your governing documents and policies are updated to allow credentialing by proxy for telemedicine services, you must establish a written agreement with the distance site where the provider is located. The originating site must see evidence from the distance site that providers are licensed in the state where the patient resides, among other details. Check out the NAMSS guidebook on credentialing by proxy for more information on what the agreement should cover. 

There are currently some interstate waivers in place, making it easier to provide telemedicine services outside of the state where the provider is located, Ponsioen says. But after those waivers expire, providers will need to be licensed in the state where the patient is receiving services. Usually, the obligation is on the distance site to confirm physician licensure in the state where they are located.

Telemedicine has been widely adopted during the pandemic and is likely to remain for the long term. During this heightened period of awareness, health systems need to put plans in place to meet patients where they are. Establishing telemedicine and credentialing by proxy at your organization allows you to continue serving your patients’ needs from the comfort of their homes.