Types of Hospital Affiliations for Providers

Why Hospital Affiliations are needed for credentialing

Commercial insurance may require a provider to have a hospital affiliation before the insurance company credentials the provider. Hospital admitting privileges allow physicians to admit patients for hospital care and serve as their attending physician during their stay. As of last year, 2023, I've seen most insurance companies require that providers have a hospital affiliation. This ensures that all patients are fully taken care of in the event of an emergency.

Several commercial insurance companies require a provider to have admitting privileges at specific hospitals with which the insurance company is connected. Other insurance companies don't have particular requirements. Some insurances will accept the lowest level of affiliation, while others require full admitting privileges. Let's look at what each level of hospital affiliation entails.

A provider can have several types of affiliations. It is best to understand each one before choosing the affiliation that best suits your practice.

1. Full admitting

2. Limited admitting

3. Non-affiliated or courtesy

4. A provider or hospital group admits on the provider's behalf

1. Full admitting or unrestricted privileges are the most common types of admitting privileges. This type of privilege allows a physician to admit patients to the hospital for any medically necessary reason, regardless of the patient's condition or the physician's specialty. Physicians with full admitting privileges typically have a long-standing relationship with the hospital and are considered medical staff members. 

2. Limited admitting privileges are a more restricted type of privilege that allows a physician to admit patients to the hospital only for specific conditions or procedures. For example, a physician who specializes in cardiology might have limited admitting privileges for patients with heart problems. Physicians with limited admitting privileges may also restrict how long they can admit a patient. 

Types of Hospital Admitting Privileges for Non-Affiliated Physicians:

While traditionally tied to employment or contractual relationships with the hospital, there are several ways non-affiliated physicians can access admitting privileges:

3. Non-admitting affiliations or courtesy privileges are the least restrictive type of admitting privilege. This privilege allows a physician to admit patients to the hospital on a case-by-case basis, but the physician is not considered a medical staff member. Courtesy privileges are often granted to physicians not affiliated with the hospital but may need to admit a patient occasionally. Typically granted to specialists for consultations or collaborating with existing staff on complex cases.

Allows occasional patient admission or consulting on admitted patients with their primary/attending physician's permission. Limited scope compared to full admitting privileges.

4. Admitting arrangements

Add if you have an admitting arrangement where another provider or hospitalist group admits on your behalf. This also includes hospitals where you have pending admitting arrangements.

Contact your local hospital for more information on their affiliation programs and what's involved to connect.