Practice Management Alert

Reader Questions:

Pocket This Common Credentialing Terminology

Question: I know some of the acronyms related to physician credentialing, like CV and NPI, but what are some others I need to look out for?

Colorado Subscriber

Answer: Credentialing requires increasingly specific knowledge, and credentialing specialists are responsible for maintaining the credentials and licenses clinicians need to work legally in their field or specialty, said Stephanie Thebarge, CPC, CPCO, CPMA, CPPM, CPB, CEMC, CHONC, owner of Seacoast Health Compliance Consultation LLC, at AAPC’s 2023 HEALTHCON.

Credentialing specialists should know the following terms well, because credentialing a clinician involves collecting, organizing, and communicating extensive recordkeeping.

ABIM: American Board of Internal Medicine

CAQH: Council for Affordable Quality Healthcare

COI: Certificate of Insurance for malpractice insurance

CV: Curriculum vitae

EHR: Electronic health record

EMR: Electronic medical record

DEA: Drug Enforcement Administration

DMEPOS: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies

Initial Appointment-Re-Appointment: Hospital privileging

NPI: National Provider Identifier

NPP: Nonphysician practitioner (Nurse practitioner, physician assistant, certified nurse midwife, etc.)

NPPES: National Plan and Provider Enumeration System

PECOS: Provider Enrollment, Chain, and Ownership System

PTAN: Provider Transaction Access Number (Medicare)

TIN: Tax Identification Number