Understanding Privileging in the Credentialing Process
When a new physician joins a hospital or healthcare organization, one of the final hurdles before they can treat patients isn’t just getting credentialed — it’s being privileged. While these terms are often used interchangeably, they serve distinct purposes within the medical staffing process. Credentialing verifies a provider’s qualifications, but privileging is what formally authorizes them to perform specific procedures and deliver certain types of care within that organization.
In today’s highly regulated healthcare landscape, privileging isn’t simply a formality, it’s a safeguard for patients and facilities alike. The process ensures that every clinician practicing within a facility has the verified skills, training, and experience to provide safe, competent care. For hospitals, it’s also a critical component of compliance with accrediting bodies like The Joint Commission (TJC), CMS,and NCQA.
Whether you’re new to medical staff services or looking to refresh your understanding of the process, this Privileging 101 guide breaks down the fundamentals from how privileging differs from credentialing to the steps, standards, and best practices that keep the process efficient and compliant.
Credentialing vs. Privileging: Understanding the Difference
Although the terms credentialing and privileging are often mentioned in tandem, they serve two distinct yet interconnected functions within the medical staffing process. Understanding the difference is essential.
What Is Credentialing?
Credentialing is the process of verifying a provider’s background, education, training, licensure, and experience to confirm they are qualified to practice medicine. It involves collecting and validating information such as medical school diplomas, residency completion certificates, board certifications, malpractice history, and professional references. In essence, credentialing answers the question: “Is this provider qualified to practice?”
What Is Privileging?
Privileging goes one step further in the verification process. Once a provider’s credentials have been verified, the organization evaluates which specific procedures and services that provider is competent to perform within its facility. This determination is based on documented training, demonstrated experience, and the organization’s established privilege criteria.
Furthermore, if a provider is looking to practice at more than one facility, they will need to obtain privileges for each institution in which they are practicing that specialty, procedure, etc. Privileging answers the question: “What is this provider qualified and authorized to do here?”
How the Two Work Together
Credentialing and privileging work together as part of the broader medical staff appointment process. Though it is more complicated than this, let’s think of the appointment process as having three main steps:
- Credentialing verifies the provider’s qualifications.
- Privileging grants permission to practice specific clinical activities.
- Appointment formalizes the relationship between the provider and the organization.
Together, these steps create a structured system that protects patients, supports clinical quality, and ensures hospitals meet stringent accreditation and regulatory standards.
The Core Components of the Privileging Process
The privileging process ensures that every provider practicing within a healthcare organization is competent to perform the procedures and services they request. While specific steps may vary, most hospitals follow a standardized structure aligned with regulatory and accreditation requirements. The process begins when a provider submits a request for clinical privileges, typically as part of their initial appointment or reappointment cycle. Providers must include documentation demonstrating competency — such as board certifications, procedure logs, training certificates, and letters of reference — with each privilege supported by verifiable evidence of education, training, and experience.
After submission, the medical staff services department reviews and verifies the application to confirm that the provider meets the organization’s established criteria. Verification includes checking primary sources, reviewing case logs, and validating specialty-specific training. The application is then forwarded to the appropriate department chair or credentials committee, which evaluates the provider’s qualifications, experience, and alignment with departmental standards. Peer evaluations or performance data may also inform the review. The committee’s recommendations are sent to the governing body for final action.
This can seem like a lengthy process for credentialing staff, especially considering that privileging is an ongoing process, not a one-time event. Implementing a protocol involving automation or using an end-to-end software like MD-Staff makes privileging a breeze. E-Priv is our source of truth for all provider information that serves as a real-time provider directory and secure read-only database for all privileging documents. To wrap up the privileging and appointment process, there is also a Virtual Committee feature for board members to view and approve providers without having to sift through tabs or folders that come across the desk.
Common Challenges and Pitfalls
Despite its importance, the privileging process can present several challenges for healthcare organizations. Incomplete or outdated documentation, inconsistent privilege delineations, and delays in committee reviews often slow down approvals and provider onboarding. Hospitals may also struggle to keep privileging criteria current with evolving medical practices or new technologies, leading to gaps in competency verification. Implementing a software or using automation is a great way to try to circumvent a bit of the issues that may naturally arise in these cases.
Organizations relying on manual processes or fragmented systems risk data errors and compliance lapses. Addressing these pitfalls through standardized forms, automated tracking, and clear communication between medical staff services and clinical leadership is key to maintaining efficiency and ultimately ensuring patient safety. Through our AI-powered solution, MD-Staff has customizable automated alerts and reminders that can help prevent overdue reappointment of privileges, notify you of expirations, and ultimately create a seamless workflow for your appointments.
The Future of Privileging
As the healthcare industry continues to evolve, so does the privileging process. The future points toward greater automation, integration, and continuous competency validation. Many organizations are moving away from paper-based or static systems toward digital credentialing platforms that centralize provider data, create more efficient workflows, and reduce administrative delays. These technologies simplify reappointment cycles and allow real-time tracking of qualifications and performance metrics. Our Privilege Library contains a vast database of provider information, with department and specialty privilege forms with your transition from paper to electronic formats in mind every step of the way.
Privileging is far more than simply a compliance requirement. It’s a cornerstone of patient safety and clinical excellence. By carefully verifying competence, aligning with regulatory standards, and continuously evaluating performance, healthcare organizations ensure that every provider practices within their verified scope and skill set. As medicine advances and technology transforms credentialing workflows, privileging must evolve alongside it — becoming more data-driven, transparent, and adaptive to emerging care models like telemedicine. Whether your organization is refining its processes or modernizing through automation or software like MD-Staff, a strong privileging framework helps protect patients, support providers, and uphold the highest standards of care.
