Delegated Credentialing in Managed Care

Delegation is a formal process by which an organization gives another entity the authority to perform certain functions on its behalf. In the managed care environment, the volume of practitioners that are required to be credentialed and recredentialed can exceed tens, even hundreds, of thousands based on the size of the plan and its geographic coverage.

There are several reasons why a managed care organization (MCO) or health plan may consider delegating all or part of its credentialing activities to qualified business partners.

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