Understanding Health Care Licensing, Certifications and Accreditation

By: Rahul Kumar on January 4, 2019

Medical licenses and certifications sound similar and may be easy to confuse—because both essentially give you permission to practice, and the terms are often used interchangeably. However, if you’re starting your own medical practice, you can’t afford to confuse them, or their significance.

  • Solo physicians starting an independent practice in the U.S. must obtain a health care license from the state government, in addition to the necessary medical education and qualifying professional degrees.

  • Certificates, on the other hand, are optional and voluntary, but they recognize your competency and skills while also adding credibility to your independent practice.

In this article, we’ll further clarify the differences between a health care license and a certification, and provide you useful information on how to best manage your license. We’ll also shed some light on the accreditation process and what it can mean for your practice.

Health Care Licenses, Certifications and Accreditations


Licenses and Certifications: What’s the Difference?

Health care licenses and certifications are two distinct things. Though the term “certification” may sound and feel like it’s describing a government or state’s approval to practice the medical profession, that’s actually not the case. The main differences between a license and a certification are described below.

License: A limited-time permission that a state government grants to a physician or doctor to start a medical practice. It’s given only after verifying that the individual meets certain standards and predetermined criteria such as education, examination and experience.

The process of obtaining a license is referred to as “licensure” and is mandatory for practicing any medical profession in the U.S. Also, renewing a license is mandatory when the tenure ends, and this differs for each state.

If you’re found running an unlicensed practice, the state you’re practicing in may pursue criminal charges and penalties against you.

Key points related to medical licenses:

  • They’re provided by state governments in the U.S. (steps listed in the next section).

  • The licensure process ensures that all medical license holders possess the minimum degree of competency required to ensure the health and safety of their patients.

  • If an individual plans to practice in multiple states, then they must obtain a license for every state. The licensing criteria usually differ from state to state.

  • Professional medical associations, such as American Medical Association (AMA) or American Association of Clinical Endocrinologists (AACE), don’t have the authority to grant a medical license. However, they can play a pivotal role in helping an individual obtain a license by advocating on your behalf.

Certification: An American Board of Medical Specialties (ABMS) member board offers a limited-duration certification to a physician or doctor after verifying that they meet the required specialty-specific standards and predetermined criteria.

Like a license, a certification must be renewed periodically according to the specific criteria of the granting board. Certifications issued by any of the 24 member boards in the ABMS indicate that a physician has the necessary medical training and proficiency in a particular specialty.

Though certification doesn’t give physicians the right to practice a state-regulated profession, it allows them to promote their certified skills and endorsement from a reputed private medical body.

Key points related to medical certifications:

  • They’re provided by any of the 24 AMBS member boards.

  • To get a certification, an individual must fulfill all the eligibility requirements specified by ABMS. They should also undergo and qualify an assessment (written, or even an oral examination) of skills and knowledge (administered by an ABMS member board).

  • Getting a certification is absolutely voluntary, as they only add to the individual’s qualifications but don’t allow them to start a practice.

  • To maintain the certification for a long time, individuals are usually required to undergo periodic retests and participate in regular training.

Now that you’re aware of the differences between a license and certification, let’s see how to apply, obtain and maintain a medical license.

How to Expertly Handle Health Care Licenses in the U.S.

Different states in the U.S. require physicians to meet different eligibility criteria to obtain a medical license. To view specific requirements by state for obtaining a license, visit the Federation of State Medical Boards’ page.

Application form: Regardless of which state you want to start your practice in, you can apply through a single application form, known as the Uniform Application for Licensure (UA) form. Let’s quickly look at the steps involved:

  1. Visit the website of the licensing board, the Federation of State Medical Boards (FSMB), and go to its Uniform Application for Licensure (UA) page.

  2. Create a login ID and fill out the UA form as directed.

    • The cost of the UA form is $60 (a one-time fee) for the first application.

    • You won’t be charged a fee for additional applications.

  3. If you have any question regarding the UA form, refer to the Frequently Asked Questions (FAQ). If that doesn’t help, contact the licensing board’s UA customer service desk by phone (800-793-7939) or email (ua@fsmb.org).

Please note, the UA form is used to apply for either single or multiple participating state medical boards. So, if you are planning to practice across multiple states in the U.S., you can apply for those specific states through a single application only. This takes care of your multistate licensure requirements.

Important tips: A few useful tips you’ll need for filling out the online UA form include:

  • Complete your FSMB Physician Profile, which is used by all state medical boards to provide licenses to physicians.

  • Submit and store your core medical documents in the Federation Credentials Verification Service (FCVS), which is referred by various state medical boards to grant a license. The FCVS data repository allows a physician to establish and maintain a confidential professional portfolio for their lifetime that can be shared with any entity (e.g., various state boards) that have an agreement with the FCVS.

  • Submit a notarized UA Affidavit and Authorization for Release of Information form to the state medical board. Please note that this UA Affidavit must be sent to the specific state’s medical board, not to FSMB or FCVS.

License renewal: A medical license is granted only for a certain time period and must be renewed after it expires. The medical license term across various states in the U.S. varies from a minimum of one year to a maximum of four years, with two- and three-year terms being the most common.

When your medical license is about to expire, you will receive alerts/renewal emails from your state medical board. You must renew your license by contacting your state’s medical board (see list with contact details) or as specified in the email. Usually, your renewal certificate and receipt will be emailed to you upon completion of the renewal.

In addition to licenses and certifications, there are a few other recognitions you should know about that may prove useful to your practice’s success.

Accreditation of Independent Practice

Other than the mandatory health care license and optional board certifications, which are granted or issued to a physician, there is a recognition granted to medical practices known as an accreditation.

Accreditation is a process of review that allows medical practices to demonstrate their ability to meet regulatory requirements or governing industry standards established by a recognized accreditation organization.

Once you start operating your small or independent medical practice, you can apply for an accreditation through any health care accreditation body. For example, the Healthcare Quality Association on Accreditation (HQAA) offers accreditation to medical practices based on the quality of patient care provided by the practice.

A successful completion of any rigorous accreditation process adds credibility to your independent practice and is also a signal to patients that your practice has undergone an exacting performance assessment and satisfied a series of qualifications regarding quality of care and patient safety.

Conclusion and Next Steps

It’s necessary to be aware of all the licenses, certifications and other associated recognitions required to start practicing in the U.S. This article should give you a head start in understanding all the medical recognitions and allow you to easily navigate the licensing process.

Armed with all the above knowledge, here’s what you should do next to help your independent practice achieve success:

  • Start the process of obtaining a medical license first by going through the steps we’ve laid out above.

  • Start the process of hiring the right medical staff, whom you’ll need as soon as you start operations. The best way to start your hiring process is by appointing a compliance officer early on. This officer will take care of all the regulatory aspects of hiring the right, qualified staff.

  • Get the best electronic medical records (EMR) software for your practice. Start your vendor selection process in tandem with hiring. Call us at (844) 686-5616 for a free consultation with an EMR software advisor. They will help you analyze your needs and find the best-suited solutions for your practice.