Credentialing by Proxy for Telehealth

Credentialing by proxy is a unique process that can simplify onboarding for telehealth providers working with hospitals or health systems. Understanding how this process works—and when it applies—can help your organization streamline credentialing, maintain compliance, and ensure timely patient care.

What Is Credentialing by Proxy?

Credentialing by proxy allows a hospital or healthcare facility (the “originating site”) to accept the credentialing and privileging decisions made by another accredited organization (the “distant site”) for telehealth providers. This process is recognized and regulated by the Centers for Medicare & Medicaid Services (CMS) and The Joint Commission.

Why Is Credentialing by Proxy Important for Telehealth?

• Efficiency: Reduces duplication of effort by allowing one organization’s credentialing decisions to be accepted by another.

• Faster Onboarding: Speeds up the process for telehealth providers to begin delivering care at new sites.

• Regulatory Compliance: Meets CMS and Joint Commission requirements for telehealth credentialing and privileging.

When Is Credentialing by Proxy Used?

• Hospitals and Health Systems: Commonly used when remote (distant site) providers deliver telehealth services to patients at a hospital or affiliated clinic (originating site).

• Accredited Organizations: The distant site must be a Medicare-participating hospital or a telemedicine entity accredited by The Joint Commission or another recognized accrediting body.

Key Requirements

• Written Agreements: There must be a formal, written agreement between the originating and distant sites outlining the credentialing by proxy arrangement.

• Information Sharing: The distant site must provide the originating site with credentialing and privileging information about the telehealth provider.

• Ongoing Monitoring: The originating site is responsible for ongoing performance monitoring and quality assurance for telehealth providers.

Best Practices

• Maintain Documentation: Keep copies of all credentialing by proxy agreements and provider files for compliance and audits.

• Verify Accreditation: Ensure the distant site organization is properly accredited and meets CMS or Joint Commission standards.

• Communicate Clearly: Establish clear protocols for sharing information and addressing any provider performance issues.

Common Pitfalls

• Missing Agreements: Failing to have a valid, written agreement can result in non-compliance and delays.

• Assuming All Providers Qualify: Not all telehealth providers or services are eligible for credentialing by proxy—verify payer and regulatory requirements.