Three Challenges Impacting Healthcare License Verifications

challenges for healthcare license verifications

Organizations across the healthcare continuum have experienced several workforce trends that are creating gaps in license monitoring and verifications. Many of these trends evolved in response to the COVID-19 pandemic, but show no signs of slowing despite a wavering rate of hospitalizations.

Hospitals and health systems continue to find themselves desperately searching for available frontline nurses to relieve their exhausted staff and make up for vacant positions due to burnout. The ongoing nurse staffing crisis is creating a multitude of complexities for hospitals and health systems, especially verifying credentials in a timely manner. And with continued increases in nurse turnover and staffing issues, reliance on a more mobile workforce and virtual health have enabled patients to receive care during a tumultuous time.

Healthcare has proven that it is adaptable in times of crisis, but as patient safety, staff retention and employee burnout remain top concerns, is your organization’s license monitoring processes keeping pace?

In this post, we’ll explore three current challenges impacting the healthcare license and credential verification process. Learn how organizations like yours can leverage better intelligence monitoring solutions to streamline workflows and keep patients safe.

Challenge #1: Poor Communication Between Compliance and HR Departments

To ensure patients receive care from qualified nurses, verifying credentials is imperative. During a time of staffing shortages, this can be a costly and disjointed process. Checking licensing boards or searching the OIG exclusion lists are responsibilities that often involve several departments, creating administrative complexities, especially for Compliance and HR departments. This elongates the process, increases the chance for errors, and ultimately prevents qualified nurses from providing care to more patients.

One suggested strategy to manage the complexities that come with the nurse staffing crisis and the credentialing process is to better connect and foster the relationship between HR and Compliance departments. When these departments are connected and complementing each other as partners, healthcare organizations benefit from efficiencies created to ensure policy adhesion, quicker credentialing processes, reduced costs, and mitigated risks. By bridging the gap between HR and Compliance departments, mutual awareness of potential issues should never come as a surprise.

Challenge #2: Inability to Implement Virtual Care Solutions

Along with widening the ability to offer virtual care, the list of eligible practitioners has expanded. If more practitioners and healthcare facilities are able to offer virtual services and expand their patient populations, the likelihood of quality care for all becomes more equitable and accessible to the communities and populations that need it most. Through virtual care, there is an opportunity to help close the gap in healthcare access to historically underserved populations.

Since 2016, the HHS Office of Inspector General (OIG) has seen a significant increase in Telehealth fraud, especially during the pandemic and public health emergency. Like license verification for in-person healthcare services, Telehealth license verification can be incredibly complex and time-consuming. A few challenges include:

  1. State medical boards vary widely
  2. Constantly evolving licensure waivers
  3. Contracting requirements with Distant Site Hospitals (DSTE)


The expanded access of virtual care to a wider population increases the responsibility of healthcare organizations to ensure their providers’ licenses and credentials are in good standing. Because of unique circumstances during COVID-19, some bad actors may be looking to take advantage of interstate licensure waivers to practice in a new state while leaving behind restrictions due to misconduct in other states.

See our Telehealth Credentialing Guide for more information.

Challenge #3: Ineffectively Monitoring Licenses for Travel Nurses

It’s easy to see why travel nursing is appealing – with higher pay rates and flexibility in location, these popular positions present new and fresh opportunities for an otherwise burnt-out workforce. These mobile, contracted positions are in high demand.

However, travel nurses prove to be a challenging population for ongoing compliance and credential monitoring. As the largest category of licensed caregivers, nurses are the most commonly excluded discipline. High demand and turnover mean they often move around which can be a strategy for outrunning disciplinary sanctions and exclusions.

For healthcare and hospital administration, it can be a challenge to stay on top of every individual licensing board across the entire country. With patient safety as a top priority, the cost of having credentials and license verification tied up in a slow process is the ability to provide care at the moment patients need it.

In addition to administrative challenges that come with monitoring this mobile workforce, the Nurse Licensure Compact (NLC), is a multi-state agreement that allows nurses to practice in any participating state, and can sometimes be tricky to monitor. It enables nurses to move across the country without obtaining any additional licenses, but the process is complicated (to say the least).

It is critical to have a credentialing and ongoing monitoring solution in place that can monitor state license boards in all 50 states. It’s important to add these nurses to your ongoing license and exclusion monitoring environment. It is similarly crucial for a solution to ensure that licenses are active and that both online and offline sources are verified.

How ProviderTrust Can Help You Solve These Challenges

ProviderTrust simplifies and automates the license and credential monitoring process for healthcare’s top HR and compliance teams in one powerful platform. Working as a complement to existing credentialing processes, ProviderTrust provides up to daily exact match results from the primary source, monitoring all 50 states and all boards. This allows healthcare organizations to focus on their patients, with in-house and contracted staff, saving time and money while ensuring credentials are always in good standing. Accessible healthcare does not have to compromise the standard of care.

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