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Introduction

After completing years of training, you are just a few steps away from starting your career. You’ve figured out your dream job and are ready to start. The only thing standing in your way is your mortal enemy—paperwork. The unfortunate truth is that paperwork is the ever-pervasive entity in your life, and before starting your job, you’ll have to jump through these hoops too.

Licensure

No matter where you plan to practice, you’ll need a state license, and you can be sure that the process is slow and painful. Once you’ve identified the state or states you want to practice in, start the process. Some of the states that have a notoriously long process are Texas, Florida, and California. These states can take well over 6 months to complete the process, and Texas even requires that you take a jurisprudence exam. To find the licensure board, a simple web search for the state and medical license will suffice. Make sure that your information is up to date and that you give a reliable address. There are also medical licensing service firms that will help you through this application process for a fee. Using these services can be helpful since you only fill out the information once, and the service sends all the appropriate data for you.

Once you’ve gotten your state license, you can now apply for your license for the US Drug Enforcement Administration (DEA). The application requires a state license to associate with, and you can apply here at https://apps.deadiversion.usdoj.gov/webforms/. This can take several weeks to months. Usually your employer can reimburse the costs involved with these license applications so you should certainly check your benefits and save all your documentation. If for some reason you cannot use these for reimbursement through your employer, you can try to claim these as part of your deductions on your tax return. Communication with your colleagues and partners along with your administrative support staff will help guide your application process.

Privileges

After you accept your contract, your employer will likely start sending you packets of paperwork to fill out. This includes forms for hospital privileges to care for patients and perform procedures. At some point of your application, you will be asked what procedures you’d like to do. Put down everything. It’s much easier to take off procedures later than to try to add them and prove you are proficient. They’ll ask for someone to corroborate your requests, so make sure to have your program director sign off on them. Prior to the completion of your training, make sure you save a copy of your operative logs from residency and fellowship training. This will be very helpful especially if you’re asking for special privileges for uncommon procedures.

Keep scanned copies of your certifications, diplomas, and letters in a clearly labeled file on your computer. You may need to submit these documents to various organizations and employer multiple times, and it will save you time if you keep them organized in an electronic format.

Stay in close contact with your office manager and the hospital credentialing office staff to ensure there are no new items popping up. And if you actually have to send anything via mail, always send it with tracking.

Insurance Enrollment

Once you get the job and finish your paperwork for state license and hospital privileges, there is still more paperwork to complete! Next comes a stack of forms from every insurance provider you’ll come in contact with, including Medicare and Medicaid. They all ask the same information, and you’ll spend a full day checking boxes and writing down the same information. My experience is that hospital credentialing staff will be providing you with assistance and to keep track of what is still outstanding. All this can take weeks to months to finalize, so it is important to file all paperwork as soon as possible. The last thing you would want is to start working and realize you cannot bill for the services you are providing your patients.

Final Remarks

The process for obtaining your state licensure and privileges is not difficult, but it does take time. Be sure to start early and keep organized. If you have an idea of the state(s) you want to practice in, start the paperwork ASAP. You may be able to have the university staff help you prior to your graduation, especially if you are staying within the same state to practice. Finalizing these details as early as possible will certainly be to your advantage as well as your employers.