Have you heard “nurse practitioner credentialing” over and over but are not quite sure what the heck it means?
You’re not alone!
Everyone seems to expect NP students and new nurse practitioners to understand credentialing, but few actually do.
Let me break down the basics of nurse practitioner credentialing, and specifically show you what YOU are responsible for versus what your EMPLOYER is responsible for!
Take a deep breath, I got you!
In this video, you’ll learn:
- The actual definition of nurse practitioner credentialing
- What credentialing allows you to do as an NP
- What you are responsible for, and the timeline you should be following
- The employer side of the nurse practitioner credentialing process, and how it affects your start date timeline!
Speaking of timelines: if you want to get your hands on my free NP Graduation Survival Kit – download it now!
Keep scrolling if you prefer toread all about credentialing in this overview of credentialing for NPs.
What Is Nurse Practitioner Credentialing?
We’re going to start with the basics today because the term credentialing is one that we hear and use a lot. But as a newer nurse practitioner or an NP student, you may not know exactly what that means.
I’m going to break it down for you in some super easy-to-understand terms and steps, so by the end of this article, you’ll have a better idea of what’s going on and what you need to do next, as a new NP. And if you want to have something in your back pocket to reference when this question comes up again, download my NP credential cheat sheet.
So what is credentialing?
As a big term credentialing is essentially you becoming legitimate as a nurse practitioner. In order to complete your credentialing process, there’s a set of things that you are responsible for as an individual.
And your employer handles another set of credentialing steps. We’ll get to that in a little bit, but first, I’m going to start with the things that you need to be doing in order for you to be credentialed.
What Are The Different Elements of Nurse Practitioner Credentialing?
First things first on the credentialing checklist: graduating nurse practitioner school!
Yes, this may seem obvious, but I get a lot of questions from NP students and new grad NPs about the exact order of operations that things need to occur, before, during, and after NP graduation. I cover the full graduation timeline in this blog post. So yes, first you need to have gone to NP school. You’ve graduated with either your MSN or your DNP, essentially giving you the education and the permission to sit for your nurse practitioner boards.
So that first element of credentialing, I guess you could say is your diploma or your transcript.
But the second thing that’s just as important, maybe even more so, is your boards.
If you are in NP school, you are in a particular tract, and you’re being prepared to sit for a particular board exam. And once you sit for those boards, and graduate, or pass them, you are issued your official certification. This is really the first major checkbox towards being credentialed. So that’s saying that you’ve been issued a board certification, and by the credentialing bodies you are recognized as a board-certified nurse practitioner.
It may be helpful to think about each element of credentialing as an umbrella. Board certifications are at the national level. There’s nothing state-specific about board certifications. Everybody regardless of what state you you live in, if you’re in the US, you are taking tests that are through a particular credentialing body. And whether you’re in New York or California, if you are an FNP, you’re taking one of two NP exams.
The next element of credentialing is your state license.
Once you have graduated and taken your boards, you can apply for your state nurse practitioner license. Now some states are different and have referred to them differently. So some states call it the APRN or the advanced practice nurse, advanced practice registered nurse license. And that’s an umbrella term because while I’m saying “nurse practitioners”, really I should recognize that our colleagues who are certified nurse-midwives and certified registered nurse anesthetists all fall under this advanced practice nursing umbrella.
So from a state perspective, this element of credentialing is going to vary state to state. You should refer to your Board of Nursing and figure out what your state recognizes you as, in terms of your license.
Here in New York, I’m an APRN, whereas when I worked in Ohio, I had a CNP, or certified nurse practitioner license. Which is why this step is important to refer to your Board of Nursing. Some states lump together the nurse practitioner in the RN license, some states don’t. And also some places you like California, for example, you have to apply for an additional registration number to be able to prescribe. So this credentialing step happens at the state level and refers to your license.
Another part of your credentialing that you’re often responsible for is your National Provider identification number or NPI.
Your NPI is something that’s federally issued and adds you to the national list of providers, like physicians, advanced practice providers, etc. This element of your credentialing process is something that’s governed through CMS, which is the Center for Medicare and Medicaid, and is really an insurance thing.
So if you are working in a cash pay clinic, then technically yes, you can practice without this. But chances are you will be working in a medical setting that bills insurance. And if so, you’ll need to get your NPI number and provide it to your employer so that when they do their end of credentialing, they have your registration number.
If you plan to prescribe, you’ll require another federally issued license: your DEA number.
The DEA stands for Drug Enforcement Administration, and this element of credentialing is confirming your permission to prescribe scheduled substances, narcotics, etc. If this is going to be part of your practice, then you will want to get this license. And if your employer offers to pay for this, this is great news! Because right now, as of 2020, it’s $731 for a three-year license. So it’s something that you will likely need from most providers, most NPS do need this, but there’s an off chance that your employer may pay for it, in which case, if you’re a new grad, and you know that your employer is going to pay for it, you can plan to have that reimbursed,.
If you end up doing this process on your own, the goodness is that it can be done completely online.
Okay, so that sums up the credentialing steps that you will be responsible for as a graduating NP. You will:
- Graduate from NP school
- Sit for your boards (and get a certification when you pass!)
- Apply for your state license
- Then for your NPI number
- And possibly apply for your DEA license.
What Parts of Credentialing Will My Employer Handle?
Now, your employer hands another side of credentialing. So these are steps they do for you, more often than not.
The first process they’ll handle is to essentially make you legitimate nurse practitioner insurance companies.
What an employer will do on your behalf is they will identify all of the documents they need from you, and submit all this information to the major insurance companies that they bill under. That way, when you see patients, they can collect money for the patients that you see, because you’re a registered provider with that insurance company. So that’s the first major thing that happens with the employer side of credentialing.
The employer side of credentialing also includes registering you with their malpractice insurance.
This should also be a conversation that you have with your employer. Do they provide malpractice insurance? Is that a benefit of your employment? And what do you need to do in addition to the malpractice insurance that they provide?
If you’re going to be seeing patients in a hospital, another aspect of the employer side of credentialing is helping you obtain medical staff privileges at the hospital.
Even though you have your license, your certification, and you’re registered with different insurance companies, each hospital also has a process for making you a recognized provider in that hospital. This allows you to see patients under the terms of their medical staff bylaws. Be warned, that this can be a long process. Even if you are already licensed as an NP. Even if you are switching jobs in the same state, and you’re already registered with all these insurance companies, this can be a lengthy process.
It’s helpful to know what’s going on behind the scenes with your employer. This way, you’re not surprised if or when the credentialing process can often be lengthy.
Can I Start Working Before Being Credentialed?
Something to note is that not being credentialed doesn’t always prohibit you from working. You can legally work as a nurse practitioner after licensing and certification. However, you may not be able to bill. Here’s how this could play out. Let’s say you have a planned orientation period that’s one or two months. It’s possible that your employer may have you start even if the employer side of credentialing is not yet complete! Because you’re allowed to work as an NP, and you may bill under a different provider during orientation.
Phew. I hope that clears things up about what credentialing is for NPs. And makes you more comfortable with your specific responsibilities.
Now that you have a better understanding of credentialing, download my free Nurse Practitioner Graduation Survival Kit. This includes an outline and glossary of all the different nurse practitioner credentialing elements we’ve discussed today. And a timeline of what you should be doing in each month before, during, and after graduation!
FAQs
What are the three steps in credentialing for NPs? ›
- NP Credentialing Process: Apply for Certification. ...
- Send Verification Information. ...
- Take the Exam. ...
- Wait for Official Certification. ...
- Apply for Licensure with the State BON. ...
- Wait for State Licensure.
All of their tests have the same number of questions, regardless of the specialty. The ANCC exam can have up to 200 questions that you'll have to complete in 3 to 4 hours. You'll have to answer a minimum of 150. This is another reason why some people consider this exam to be harder.
What is the easiest NP program to get into? ›- MSN - Nurse Practitioner University of Southern California Online. ...
- MSN - Family Nurse Practitioner Spring Arbor University. ...
- MS in Nursing - Family Nurse Practitioner Walden University. ...
- Master of Science in Nursing - FNP Wilkes University.
Becoming a Certified Nurse Practitioner isn't easy, and yes, both the AANP and ANCC certification exams are challenging — very challenging. They will take a great deal of analytical thought, clinical judgement, and preparation.
What are four types of credentialing requirements that you would need to understand before beginning a job search in complementary or alternative medicine? ›Requirements may include establishing competency (such as proof of training), licensure or certification, background checks, continuing education hours, proof of malpractice insurance coverage, and experience working in the field or specifically in a hospital or research setting.
What are the four essential elements the regulation of the Aprn consists of? ›APRN Regulation includes the essential elements: licensure, accreditation, certification and education (LACE). Licensure is the granting of authority to practice.
How many questions do I need to get right on ANCC FNP exam? ›To pass the ANCC examination, an examinee must achieve a scale score of 350 or higher. Prior to conversion of an examinee's score to this scale, the examinee's raw score on the examination is determined, which is simply the number of test items that the examinee answered correctly (e.g., 105 out of 150).
How many times can you fail NP boards? ›What happens if I fail the exam? ANCC: If you fail the ANCC FNP exam you will have the ability to retake the test after 60 days of the last testing date; however, you cannot take the exam more than three times in any 12 month period.
What is the pass rate for ANCC exam? ›ANCC Pass Rates: In comparison, 86.6% of test takers passed the ANCC exam on their first try in 2021.
Which NP specialty is the hardest? ›- Adult Acute Care Nurse Practitioner. ...
- Oncology Nurse Practitioner. ...
- Psychiatric Nurse Practitioner. ...
- Emergency Nurse Practitioner. ...
- Armed Forces NP. ...
- Adult-Gerontology Nurse Practitioner. ...
- Correctional Nurse Practitioner. ...
- Substance Abuse Nurse Practitioner.
What type of NP gets paid the most? ›
As a hospitalist NP, you can expect to have one of the highest-paying nurse practitioner jobs. The average yearly wage is about $117,880. And while hourly rates vary based on region and specific hospitals, it is $56.67 on average.
Which NP is most needed? ›- Family (70.3%)
- Adult-Gerontology Primary Care (8.9%)
- Psychiatric/Mental Health (6.5%).
Allow a minimum of 4 to 6 weeks of planned study after you complete the review course to maximize your likelihood of success on this important high-stakes exam.
What is the hardest class in NP school? ›Primary care for the older adult is another one of the hardest classes in family nurse practitioner school. The course focuses on disease prevention, health promotion, and management of common acute and chronic diseases in the older adult.
What are the two types of NP exams? ›You're nearing the end of your Nurse Practitioner program and it is time to consider which certification exam to take. There are currently two recognized certifying boards for NPs: The American Nurses Credentialing Center (ANCC) and the American Association of Nurse Practitioners (AANP).
What is the most common form of credentialing? ›Multiple-choice questions are the most commonly used format for credentialing exams, particularly for exams that focus on measuring knowledge domains. An extensive amount of research supports the effectiveness of this type of question for credentialing exams.
What are the major methods of credentialing? ›Credentialing in health care is a process intended to assure some quality of service or some level of compe- tence on the part of an institution or individual health care provider. Three primary mechanisms for credential- ing include licensure, certification, and accreditation.
What are the 3 most important criteria in order of importance that you would require before you accept a position? ›- Research Your Prospective Employer. Your prospective employer has worked hard to assess your suitability for the job. ...
- Salary. ...
- Benefits and Perks. ...
- Savings and Expenses. ...
- Time. ...
- Career Path. ...
- Research the Role. ...
- Your Values.
The four pillars of advanced practice are clinical practice, leadership and management, education, and research.
What are the seven core competencies of APRN? ›Core competencies include direct clinical practice, guidance and coaching, consultation, leadership, evidence-based practice, collaboration and ethical decision making. NPs are expected to possess and employ these competencies, which constitute extensions to the nursing role.
What are the seven domains of nurse practitioner practice? ›
The competencies are organized in seven content domains: Management of Patient Health/Illness Status, The Nurse Practitioner-Patient Relationship, The Teaching-Coaching Function, Professional Role, Managing and Negotiating Health Care Delivery Systems, Monitoring and Ensuring the Quality of Health Care Practices and ...
Can I take AANP if I fail ANCC? ›If you fail the AANP exam, can you take the ANCC exam (and vice versa)?* The AANP and the ANCC are completely separate organizations and they do not communicate about an individual's exam status. * You may take and retake either exam as long as you meet the board's eligibility requirements for testing and retesting.
What is the pass rate for AANP and ANCC? ›The pass rates are not very different; for 2021, the AANP pass rate was 84% (for FNP), and the pass rate for the ANCC was 87% (for FNP). The cost is similar; as of this writing, the AANP test is $315, and the ANCC test is $395, and both organizations offer a discount to their members.
What happens if you fail an ANCC? ›If you do not pass a certification exam, you may apply to retest after 60 days. Applicants may not test more than 3 times in any 12 months. Please wait 5 days after examination to submit a retest application online.
Which is harder ANCC or AANP? ›The AANP is rumored to be the easier of the two exams, specifically for those seeking their FNP certification since it has a 5% higher pass rate than that of the ANCC FNP exam. Using the pass rate as a basis for difficulty then you can reasonably say that the AANP exam is easier than the ANCC.
What are the types of questions on the ANCC exam? ›This examination includes four types of questions: 1) multiple choice; 2) multiple response; 3) drag and drop; and 4) hot spot. Most of the test questions are multiple choice. The sample questions below are intended to help you get an idea of the type of content on the exam.
What is the difference between FNP C and FNP BC? ›Perhaps most importantly, the certification exams have different scopes. The FNP-C is meant for FNPs who plan to go into clinical practice. The FNP-BC is aimed at nurse practitioners who want to make an impact on the profession as a teacher or policymaker (although they are still licensed to practice).
What is the highest score on ANCC? ›Scores on ANCC examinations are reported on a scale with a maximum possible score of 500.
Does ANCC tell you your score? ›ANCC reports its examinees' test score results as pass or fail. If an examinee fails, the score report includes diagnostic feedback for each of the major content areas covered on the examination.
How many times can I take the AANP exam? ›It is AANPCB policy to limit a candidate to two (2) testing attempts per calendar year (January 1st to December 31st) in order to avoid examination item compromise. To retake the examination, apply online using either the online or paper Retake Application option.
What state pays NPs the most? ›
- 1. California. According to data from the U.S. Bureau of Labor Statistics, California is the highest paying state for nurse practitioners. ...
- New Jersey. ...
- Washington. ...
- New York. ...
- Massachusetts. ...
- Nevada. ...
- Minnesota. ...
- Wyoming.
A Doctor of Nursing Practice (DNP) is a terminal educational degree, while a nurse practitioner (NP) is a professional role and job title. Nurse practitioners can be prepared at the master's level or earn a DNP degree. As you explore advancing your nursing career, you may be comparing DNP vs master's NP programs.
What is the hardest floor to work on as a nurse? ›- Intensive Care Unit (ICU) nurses. ICU is an extremely high-pressure environment and these nurses work with patients who have significant injuries and disease with added morbidity risks. ...
- Emergency Department nurses. ...
- Neonatal ICU. ...
- OR nursing. ...
- Oncology Nursing. ...
- Psychiatric Nursing.
The average annual salary for a Nurse Practitioner is $118,040. The bottom 10% of average annual NP salaries is $79,470. The top 10% is $163,350 per year. The median annual wage for a Nurse Practitioner is $120,680.
Does PA or NP get paid more? ›Do PAs make more than nurse practitioners? PAs and NPs earn similar salaires. According to the BLS, NPs earned a median salary of $120,680, and PAs earned a median salary of $121,530 in 2021. Outpatient care centers are the highest-paying workplaces for both roles.
Are nurse practitioners millionaires? ›So, are nurse practitioners rich? Once again, rich is a relative word, but nurse practitioners can earn a healthy average wage. The starting salary for a nurse practitioner is $82,969 per year. This income is an excellent way to start your NP career at a very livable wage that will increase with experience.
How many patients should an NP see an hour? ›The majority of full-time NPs (56.9%) see three or more patients per hour. NPs have been in practice an average of 9 years. The average age of NPs is 46 years.
What is the ideal age to become a NP? ›The mid to late 20s is a great time to apply to NP school if you know, as a young nurse, this is the career path you want to pursue.
Is the nurse practitioner field becoming saturated? ›Many job markets across the U.S. are saturated for nurse practitioners. Many are not. Regardless of the situation in your area, if you're a new grad you may need to be determined and flexible as you look for that coveted first position.
Can I challenge the NP exam? ›Examination Appeals
Denial of eligibility of an individual to take the certification examination may be appealed. The candidate shall assume responsibility for providing adequate documentation to support the appeal.
How many questions is the NP exam? ›
Initial Certification Application
The exam allows 3.5 hours to answer 175 questions (150 scored plus 25 pretest questions that are not scored).
Many schools will require a 3.0 GPA to get into nurse practitioner school. Based on the type of NP program you are applying for (MSN or DNP), your GPA will be calculated from your bachelorly or master's degree coursework.
What is the easiest nursing class? ›...
The Easiest Classes in Nursing School
- Social Sciences (Intro Psychology, Sociology, etc.)
- Humanities.
- Intro to Speech (or Communication)
- English Composition.
- History.
- Using Information Technology.
These are 3-5 year programs, where you will take both the NCLEX to earn your RN but also complete a master's or doctorate program to become an NP. It's not just the duration of training, but also the competitiveness and rigor of each path. Getting into medical school is by far the most competitive of the three.
What percentage is passing on NP boards? ›American Nurses Credentialing Center (ANCC) | American Association of Nurse Practitioners (AANP) |
---|---|
Questions: 175 – 200 | Questions: 150 |
Length: Approximately 4 hours | Length: 3 hours |
2021 Pass Rate: 87% | 2021 Pass Rate: 84% |
The process is the verification and assessment of a physician's education, training and experience. It allows patients to trust that they're in good hands and physicians to have trust in their peers. Credentialing also plays a part in physician health plan enrollment so that payment for services can be received.
What three steps must an NP student complete in order to become a CRNP in the state of Pennsylvania? ›- Master's Degree. ...
- 1 Exam. ...
- No Experience requirement for licensure.
- 3 Hours.
- Applicants must complete 3 hours of Board-approved continuing education in child abuse recognition and reporting for initial licensure.
- $100.00 – Fee for applicants educated in-state.
Credentialing is the process the healthcare facility or managed care organization/health plan uses to collect and verify the “credentials” of the applicant. This includes verification of many elements including licensure, education, training, experience, competency, and judgment.
What is your greatest strength as a credentialing specialist position? ›- Ability to complete thorough research.
- Organization.
- Teamwork.
- Database management.
- Understanding of laws, regulations and procedures.
- Computer proficiency.
- Familiarity with medical terminology.
Credentialing solutions consist of features that streamline the process of obtaining the documentation from providers and verifying their authenticity, not to mention reducing the costs involved.
What are the two types of certification for an NP? ›
- Family Nurse Practitioner Certification (FNP)
- Adult-Gerontology Primary Care Nurse Practitioner Certification (A-GNP)
- Emergency Nurse Practitioner Certification (ENP)
The NP Role Core Competencies are acquired through mentored patient care experiences with an emphasis on interprofessional practice; use of technology to deliver and enhance patient and population health outcomes; analytic skills for evaluating and providing evidence-based, person-centered care across settings; and ...
How to succeed at NP Clinical? ›- Tip #1: Get to Know Your Clinical Preceptor, Staff, and the Community.
- Tip #2: Prioritize a Patient's List of Concerns at Every Visit.
- Tip #3: Learn to Communicate Well with the Patient.
- Tip #4: Learn to Give a Well Thought-Out Patient Presentation to the Preceptor.
Credentialing is a vital process for healthcare institutions. In simple terms, credentialing is the process of assessing the academic qualifications and clinical practice history of a healthcare provider.
Which of the following is the most rigorous form of credentialing? ›Answer and Explanation: The correct answer is c): Certification. A "credential" is a term that is described as a type of document that consists of qualification,...
What is an example of credentialing? ›Examples of Credentialing Documentation. Completed using government-issued picture identification. Completed using government-issued picture identification. Primary source verification directly from the state licensing agency/body.
How do I organize my credentialing files? ›- Maintain Separate Files. ...
- Label the sections in order of HRSA requirements. ...
- Develop checklists to make sure files are up-to-date. ...
- Review the HRSA Site Visit Protocol at least annually. ...
- Train frequently.
Professional references (or peer recommendations) are an important step in the credentialing effort—they offer peers an opportunity to verify the clinical competency of a provider. They can provide valuable information that might otherwise be unavailable regarding an applicant.
How do you write credentialing? ›- Include your academic degrees. ...
- List your professional licenses. ...
- Add your state designations or requirements. ...
- Include your national certifications. ...
- List any other certifications you have.