Credentialing by proxy holds promise in streamlining the credentialing process by reducing the hours spent on paperwork and the length of time it takes to privilege telemedicine providers, says Mandy Bell, founding board member of the newly formed American Board of Telehealth and innovation officer of Avera eCare.

“This is especially important in rural and community hospitals where resources are limited and there may not be specialty peers to review credentials,” she says.

Hospitals contracting for credentialing by proxy work with their medical staff office to help them understand they will receive only minimal information about the providers, as they are relying on the distant site to have completed a full review. They still are required to review this “skinny file” and run provider queries through the National Practitioner Data Bank, Office of Inspector General, and System for Award Management, as applicable.

Hospitals also must complete some internal review of these providers. At a minimum, this review must document and report back to the originating site all adverse events and complaints.

“The main downside of credentialing by proxy is less control of credentialing and privileging by the onsite medical staff. They will not receive a full packet of credentialing information to review, nor Ongoing Professional Practice Evaluation data from the distant site,” Bell says. “Medical staff members should buy in and champion this for their facility. Bylaws often need to be revised to allow for this reliance.”

The medical staff office needs education on this new process as well as staff time to work through the details with the distant site.

“While privileging by proxy won’t work for every healthcare situation, it is a great option for facilities that contract for telemedicine services,” Bell says. “Credentialing by proxy can save time and money, ultimately shortening the time to operationalize telemedicine.”


  • Mandy Bell, Innovation Officer, Avera eCare, Sioux Falls, SD. Phone: (888) 452-6123.