National Maternal and Child Oral Health Resource Center | Georgetown University
Unit 4: Administrative Operations
Administrative Operations

Section 2. Human Resources

Credentialing and Privileging

Credentialing consists of verifying the health professional’s graduation from an accredited program, post-graduate specialty training (if applicable), past history of practice (through letters of recommendation and inquiry to the National Practitioner Data Bank), and current licensure. All licensed health professionals, as well as all support personnel requiring state certification (e.g., certified dental assistants), should undergo the credentialing process.

Privileging is accomplished through each facility and is the process by which the health professional's scope of services at the facility is defined. The granting of privileges is based on the health professional's training and experience and practice history and the ability of the facility to provide the support and services for which he or she is privileged. In health care facilities with an organized medical and dental staff, a committee of health professionals and peers recommends the privileges to grant, based on the qualifications of the applicant. The final authority for granting of privileges generally rests with the governing body or board of directors. In a small community dental clinic, where there may be only one dentist on the staff, the chief executive officer (CEO) or the board of directors would grant privileges.

In 1965, the landmark legal decision Darling v. Charleston Community Hospital helped to establish the principle of corporate liability in the health care industry. Simply stated, this means that the clinic can be held legally liable for the actions of those it employs (including contractors and volunteers). Proper credentialing helps to ensure that only fully qualified health professionals work in the clinic and that they do not practice outside the limits of their training and expertise or beyond the capabilities of the clinic to support the services being provided (e.g., sedation, general anesthesia).

Samples of credentialing and privileging packages may be obtained from most hospitals and ambulatory care facilities. Click on these links for a sample privileges request form and an application for staff appointment:

1. Application

  • The application for staff appointment must be completed and approved by the human resources (HR) department and a copy sent to the dental director before the dental privileges request form can be initiated.
  • HR will send the dental privileges request form to the dentist, who will complete the general privileges and expanded package procedures sections.
  • The form will then be sent to the dental director, who will determine in which sections the dentist will be privileged.

2. Privileging determination
General privileging: All dentists will be privileged in every section of the general privileges section, with the following exceptions:

  • Problems noted in the credentialing process
  • Prearranged agreement between the dental director and the dentist to limit the dentist’s practice
  • Dentist is a specialist and needs privileging in only a limited area of dental specialty

Expanded package procedures: Only dentists with demonstrated skills will be privileged by the dental director in these areas. Demonstrated skills will be determined by any of the following: 

  • Specific documented training beyond the traditional 4-year dental school program
  • Proctoring by a dentist designated by the dental director to oversee those specific procedures

3. Re-privileging of a dentist
Dentists will be re-privileged every 2 years under a similar process of initial privileging. A dentist can ask for a change in privileges at any time. 

4. De-privileging of dentist
The agency holds the right to de-privilege an oral health professional dentist in all or specific treatment areas. The de-privileging process can be initiated only by an investigation conducted according to the formal peer-review process as a result of a specific detrimental patient outcome, a series of outcomes that cast doubt on a dentist’s skill level, or persistent and uncorrected problems in patient charting. The recommendation to de-privilege must be approved first by the credentialing committee and finally by the board of directors.

(Source: Yakima Valley Farm Workers Clinic)

Resource

  • ADA Credentialing Service, available to any practicing dentist in the United States, allows you to submit and maintain your credentials in one central place, making your information accessible to you and the participating organizations you choose.