Economic credentialing

1. Process by which a managed care plan takes a physician’s economic behavior into account and endorses that a physician is competent to render medical services to members of the plan. A physician’s economic review might include tests ordered, hospital bed days, and outcomes. See also provider profiling . 2. Related to a hospital setting, it enables a hospital to obtain control over economic factors that affect the quality of medical care and range of medical services that a hospital can provide. 3. Analysis of claims and benefits data to identify cost, use, and quality of care by physicians, health care facilities, and allied health providers.

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