Credentialing by Proxy Blog

A Deep Dive into CredentialStream's Credentialing by Proxy (CBP) Features

January 2, 2024
January 2, 2024

Transforming Telehealth Credentialing

Each year, HealthStream® conducts a comprehensive survey on Medical Staff Credentialing, aiming to capture evolving trends that inform the evaluation and management of credentialing operations. In the tumultuous year of 2020, otherwise known as the year of the COVID-19 pandemic, a distinctive trend emerged: the widespread adoption of telehealth. Notably, our 2021 survey revealed that 51% of respondents experienced a significant increase in the utilization of telehealth services during the preceding year.

Fast forward three years from the peak of the pandemic, and the popularity of telehealth is undeniable. Its numerous advantages are too significant to overlook, including heightened patient access, an expanded geographical reach for provider expertise, cost efficiencies benefitting both providers and patients, elevated quality of care, risk reduction, and more. However, despite the wealth of positives associated with the adoption of telehealth, it has not been without its challenges.

“Importantly, telemedicine has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases (which account for about 75% of healthcare costs); by allowing shared health professional staffing, reduced travel times, fewer admissions, and shorter lengths of stay."

Source: NAMSS-ATA Credentialing by Proxy Guidebook

Telehealth Results in a Surge in Credentialing Inquiries

The proliferation of telemedicine has brought about a surge in credentialing inquiries as a growing number of practitioners seek telemedicine privileges across multiple facilities. Consequently, this has placed new demands on today’s Medical Services Professionals (MSPs). According to our 2022 survey on Medical Staff Credentialing, a significant portion—38.3 percent—of respondents reported that privileging telehealth providers was challenging. Nearly half (45.1 percent) of respondents attributed the challenges to the intricacies of evolving regulations and their dynamic nature. Furthermore, a shortage of both qualified staff (38.3 percent) and staff with adequate knowledge (25.4 percent) were also identified as key obstacles.

The fact is, conventional credentialing procedures are both burdensome and costly.  Hospitals seeking to bring on telemedicine services for the benefit of their patients often grapple with insufficient personnel and a lack of specialized expertise to efficiently process the growing influx of telemedicine applications. In response to this challenge, MSPs are actively seeking innovative ways to minimize administrative overhead and ease the burden on providers. Enter Credentialing by Proxy (CBP), an emerging alternative process that streamlines the credentialing of telemedicine practitioners.

Credentialing by Proxy Defined

According to NAMMS, “Credentialing by proxy is a relatively new process by which hospitals using remote practitioners for telemedicine services can accept the remote hospital’s credentialing work, rather than requiring the full traditional credentialing process for practitioners who may never step foot into that facility.” Specifically, this allows the hospital receiving telehealth services (known as the “Originating Site” hospital) to rely on the privileging and credentialing decisions made by the hospital or entity providing the telehealth services (known as the “Distant Site” hospital or “Distant Site Telemedicine Entity” respectively), so long as certain requirements are met.

Credentialing by proxy (CBP) not only addresses the challenges faced by Originating Site hospitals responsible for credentialing functions but also benefits telemedicine practitioners striving to offer their services at these hospitals. In our recent 2023 survey on Medical Staff Credentialing, more than half (51.7 percent) of respondents reported actively utilizing CBP for telehealth providers.

CredentialStream and Credentialing by Proxy

The requirements and processes used to establish and implement a CBP program will differ from organization to organization. But to keep track of practitioners credentialed by proxy, Originating Sites need an efficient way to store and monitor data. This data may include the most updated practitioner roster, license verifications and privilege delineation, and agreement details/dates. Storing this data safeguards the organization and simplifies the process for presenting to an accreditor, should a survey include questions about telemedicine.

In response to the popularity of CBP, CredentialStream ® by HealthStream, has undergone significant updates. These recent enhancements focus on enabling a healthcare organization to effectively identify and store Distant Site Facility data and offer a mechanism for associating the Distant Site and relevant data fields to the Originating Site.

Highlights of Updated Features:

  1. Facility Table - Distant Site Identification:

    The Facility table now includes a feature to identify Distant Site Facilities designated for Telehealth credentialing by proxy.

    • Activating the toggle for distant site designation automatically adds the facility to a dedicated table that will be utilized in the Provider Facility record area to connect the Originating Site to the Distant Site.
    • A new icon in the Facility table provides instant visual identification of Facilities set up for Distant Site purposes.
  2. Provider Facility Screen - Credentialing by Proxy Functionality:

    The Provider Facility screen now includes a new toggle called Credentialing by Proxy. When toggled to "Yes," the following new fields will display:

    • Telehealth Distant Site: Enables CredentialStream users to select a Distant Site Facility identified in the Facility table.
    • Telehealth From Date: Allows users to specify the start date of the telehealth agreement with the selected provider.
    • Telehealth To Date: Indicates the next recredentialing date specified in the telehealth agreement, typically aligned with the reappointment date at the distant site.
  3. Credentialing Quick Edit for Facility:

    The Credentialing Quick Edit for Facility has been updated to incorporate data fields for Distant Site, From Date, and To Date. This enhancement streamlines the quick editing process, ensuring that all relevant information for telehealth credentialing is easily accessible and editable.

    These updates collectively empower healthcare organizations to identify, store, and efficiently manage Distant Site Facilities, ultimately streamlining the credentialing by proxy process and expediting the onboarding of telehealth providers within CredentialStream.


Telehealth is here to stay. CBP has the potential to dramatically increase the speed and efficiency of credentialing and privileging remote telemedicine practitioners, saving time and money, and providing easier, expanded care and services to patients. While there may be a learning curve to adopting the process, CredentialStream has the functionality needed to successfully launch and manage a successful CBP program at your facility. Contact us to learn more.