Organization Charts

Organization Charts in the Credentialing Process

An organization chart (org chart) is sometimes required during the healthcare credentialing process. Understanding what an org chart is, why it may be requested, and how it supports your application can help ensure a smooth onboarding and compliance experience.

What Is an Organization Chart?

An organization chart is a visual diagram that outlines the structure of your organization. It shows the hierarchy, reporting relationships, and key roles within your group, clinic, or facility. Org charts typically include:

• Owners and board members

• Executive leadership (e.g., CEO, Medical Director)

• Department heads and managers

• Key clinical and administrative staff

Why Is an Organization Chart Needed for Credentialing?

1. Verifies Ownership and Control

Credentialing bodies, insurance payers, and regulatory agencies often require a clear picture of who owns, controls, and manages your organization. An org chart:

• Illustrates the chain of command and reporting relationships

• Identifies individuals with ownership or controlling interests

• Supports ownership disclosure requirements

2. Ensures Regulatory Compliance

Many payers and state agencies require org charts to:

• Confirm compliance with federal and state regulations regarding ownership and control

• Identify potential conflicts of interest or prohibited relationships

• Trace indirect ownership through parent companies or holding entities

3. Clarifies Roles and Responsibilities

An org chart helps credentialing reviewers understand:

• Who is responsible for clinical oversight, administration, and compliance

• The structure of departments and reporting lines

• How decision-making authority is distributed within the organization

4. Supports Large or Complex Organizations

For larger groups, multi-site practices, or organizations with layered ownership, an org chart is especially important. It provides a clear, visual summary that simplifies complex structures for reviewers and payers.

When Is an Organization Chart Required?

• Group Practices and Facilities: Frequently required for group credentialing, especially if there are multiple owners, managers, or locations.

• Medicare/Medicaid Enrollment: Often requested to verify ownership and control interests.

• State Licensure: Some states require org charts as part of the facility licensing process.

• Commercial Payer Credentialing: May be requested for larger organizations or those with complex structures.

Solo practitioners or very small practices may not always need to provide an org chart, but it is best to check each payer’s requirements.

What Should Be Included in an Organization Chart?

• Legal business name and any DBAs

• All owners (individuals and entities) with their titles/roles

• Board members and executive leadership

• Department heads and key managers

• Reporting lines (who reports to whom)

• Date the chart was last updated

Best Practices

• Keep it current: Update your org chart whenever there are changes in ownership, leadership, or structure.

• Be clear and accurate: Ensure all names, titles, and relationships match your other credentialing documents.

• Submit as requested: Provide the org chart in the format (PDF, image, etc.) specified by the payer or agency.