The Locum Tenens Credentialing Process: What Medical Staff Offices Actually Need to Get Right

Credentialing a permanent physician is slow. Credentialing a locum tenens provider is slower, more complex, and carries higher stakes if something gets missed.

The locum tenens credentialing process covers the same verification requirements as a permanent hire: licensure, education, training history, board certification, malpractice, DEA, and NPDB queries. But it runs on a compressed timeline, across multiple state jurisdictions, and often with incomplete application packages arriving from staffing agencies.

Industry benchmarks put the standard credentialing cycle at 60 to 120 days. For locum providers who need to be seeing patients in two to three weeks, that gap between regulatory requirement and operational reality is where most medical staff offices struggle. Facilities that get this wrong risk Joint Commission findings, CMS deficiencies, and delayed revenue from providers sitting idle while paperwork catches up.

This article walks through the locum tenens credentialing process from application intake to privilege approval, identifies the stages where delays and errors cluster, and outlines how high-performing medical staff offices are compressing timelines without cutting corners.

Permanent hires get credentialed once. Locum providers get credentialed constantly.

A staff physician at a single hospital system goes through initial credentialing and then recredentialing every two years. Over a 20-year career, that might total 12 credentialing events.

A full-time locum physician working year-round could go through four to six credentialing processes annually, each at a different facility with different bylaws, different committee structures, and different documentation requirements. Over the same career span, that is well over 100 credentialing events. And each one carries the same regulatory weight as an initial appointment.

The volume problem is compounding. CHG Healthcare's 2025 State of Locum Tenens Report found that locum tenens appeared in 16.4% of all physician employment searches in 2024. That is the highest rate the survey has ever recorded. Eighty percent of healthcare organizations plan to maintain or increase their locum usage through 2025 and beyond. One in three eligible US physicians has now worked at least one locum assignment.

For medical staff offices, this means the credentialing process built for a handful of new permanent hires per quarter now needs to handle a steady flow of temporary providers, each requiring full verification, committee review, and privilege delineation on a timeline measured in days rather than months.

Six stages of the locum tenens credentialing process

The specific workflow varies by facility, but the locum tenens credentialing process follows a consistent sequence at every organization subject to CMS, Joint Commission, or NCQA standards.

1. Application intake and completeness review

The process starts when the staffing agency submits the provider's application and supporting documentation. For most facilities, this includes the completed credentialing application (often facility-specific or CAQH ProView), copies of medical school diploma and residency certificates, current curriculum vitae, state medical license copies for each state of practice, DEA registration, board certification documentation, malpractice insurance certificate, professional references (typically three peer references), and a signed attestation statement.

The completeness review is the first bottleneck. Applications from staffing agencies frequently arrive with missing documents, expired copies, or forms filled out for a different facility's requirements. Medical staff coordinators report spending significant time chasing missing items before verification can even begin. Agencies with dedicated hospital privileging teams tend to produce cleaner packages, but the facility's medical staff office owns the final check.

2. Primary source verification

This is the most time-consuming stage and the one with the least room for shortcuts. CMS, the Joint Commission, and NCQA all require that credentials be verified through the original issuing source, not through copies, agency attestations, or third-party summaries.

Primary source verification must cover medical education (confirmed with the medical school or ECFMG for international graduates), residency and fellowship training, board certification status (directly from the certifying board), state licensure in every state where the provider will practice, DEA registration, and NPDB continuous query or point-in-time query.

For a locum provider licensed in four states with fellowship training at a different institution than their residency, the verification process generates a minimum of eight to ten separate queries. Each one requires outreach to the issuing body, a response wait period, and documentation of the result. State medical boards alone can take anywhere from a few days to several weeks to respond.

3. Malpractice and disciplinary history review

The NPDB query is the baseline, but it is not the only data point. Medical staff offices should review the provider's five-year malpractice claims history, including open claims, settlements, and judgments. State medical board disciplinary records should be checked in every state where the provider holds or has held a license.

Locum physicians who have practiced across multiple states may have disciplinary actions or malpractice events in jurisdictions the facility would not ordinarily check. A provider with a clean record in Texas might have a settled claim in California that only shows up if someone looks. The NPDB catches federal actions, but state-level board actions can take months to appear in the national database.

4. Committee review and privilege delineation

Once verification is complete, the credentialing package goes to the facility's credentials committee for review. For permanent hires, this committee typically meets monthly. For locum providers who need to start within weeks, some facilities have established expedited review pathways that allow the committee chair or medical staff president to approve temporary privileges between regular meetings.

Privilege delineation for locum providers should match the specific procedures and clinical activities the provider will perform during their assignment. A locum hospitalist and a locum orthopedic surgeon require very different privilege sets. The delineation should reflect the facility's existing privilege criteria and the provider's verified competence.

5. Temporary privileges: when and how to use them

CMS and the Joint Commission both allow temporary privileges for situations where a verified application is pending committee action, or where an important patient care need exists. Temporary privileges are not a workaround for incomplete verification. They require that the provider's licensure has been verified, the NPDB has been queried, there is no currently known basis for denial, and the medical staff president (or designee) has approved the temporary grant.

Temporary privileges typically last 120 days or until the next committee meeting, whichever comes first. The documentation trail for temporary privilege decisions must be audit-ready, because surveyors look specifically at how facilities handle this pathway.

6. Onboarding, FPPE, and ongoing monitoring

Credentialing does not end when privileges are granted. The Joint Commission requires Focused Professional Practice Evaluation for all newly privileged practitioners, including locum providers. FPPE criteria should be defined before the provider starts and typically include chart reviews, direct observation, or proctoring for procedural specialties.

Ongoing monitoring covers license and certification expirations, NPDB continuous query alerts, and any changes in the provider's status at other facilities. For locum providers who return for multiple assignments, the facility needs a clear policy on when full recredentialing is required versus an expedited reverification.

Three stages where most of the 120-day timeline gets burned

When a locum credentialing file takes 90 days instead of 30, the delay rarely comes from a single point of failure. But three stages account for a disproportionate share of the elapsed time.

Application completeness. Incomplete packages from staffing agencies can add two to four weeks before verification even starts. Every missing document requires outreach to the agency, who then chases the provider, who may be mid-assignment at another facility. A standardized intake checklist, shared with agencies before they submit, reduces the back-and-forth.

Primary source response times. State medical boards and training institutions respond on their own schedule. Some return verifications in 48 hours. Others take four to six weeks. For providers licensed in multiple states, these response times run in parallel but the slowest board sets the pace. Automated verification systems that query electronic databases cut this window significantly for the boards that support digital verification.

Committee scheduling. A monthly credentials committee that meets on the 15th means a file completed on the 16th waits 29 days for review. Facilities with high locum volume need either a more frequent committee schedule, an interim approval pathway with appropriate safeguards, or both.

How facilities are cutting the credentialing cycle without cutting corners

The fastest medical staff offices are not skipping verification steps. They are removing the dead time between them.

Automated primary source verification is the single biggest time saver. Instead of manual outreach to each board and institution, platforms that connect directly to electronic verification databases can return results in hours rather than weeks for participating sources. Not every source supports electronic verification yet, but the ones that do, including many state medical boards, the ABMS for board certification, and the NPDB for continuous query, cover the most time-intensive checks.

Credentially automates primary source verification across the full credentialing file, tracking status in real time and flagging items that need manual follow-up. For organizations managing a mix of permanent and locum providers, the platform reduces credentialing cycles by 60 to 70%, compressing a 90-day process to 30 to 45 days. For a 200-provider organization, that kind of reduction means 15 or more hours per week returned to the medical staff office, and providers generating revenue two months earlier than they would on a manual timeline.

Expiration management is the other piece. A credentialing file that was complete on day one becomes non-compliant the moment a license or certification expires. Automated tracking with advance alerts, 90 days, 60 days, 30 days before expiration, prevents the lapse-and-scramble cycle that ties up coordinators and creates survey risk.

None of this replaces the medical staff office's judgment or the credentials committee's authority. Automation handles the data collection, verification, and tracking. The committee retains its role in reviewing the complete file and making the privileging decision.

Getting the process right matters more as locum volume grows

The US physician shortage is projected to reach 86,000 by 2036. Each unfilled position costs hospitals $7,000 to $9,000 per day in lost revenue. Locum tenens providers fill that gap, but only if they can be credentialed fast enough to actually start seeing patients.

Medical staff offices that treat the locum tenens credentialing process as a structured, trackable workflow, rather than a paper chase, are the ones compressing timelines from 120 days to 45 without creating compliance exposure. They verify from primary sources, document every step, track expirations before they lapse, and give credentials committees the information they need to make confident decisions.

For teams evaluating how their current credentialing process performs against the demands of growing locum volume, Credentially provides a compliance and workflow assessment that identifies where time is being lost and what can be recovered.

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 Sources

•  AAMC, The Complexities of Physician Supply and Demand: Projections From 2021 to 2036 (March 2024)

•  CHG Healthcare, 2025 State of Locum Tenens Report (October 2025)

•  CHG Healthcare, 2024 Client Awareness & Perception Study

•  Staffing Industry Analysts, US Locum Tenens Market Growth Assessment 2025

•  NAMSS, Ideal Credentialing Standards, revised January 2024

•  CMS Conditions of Participation for Hospitals (42 CFR 482)

•  The Joint Commission, Medical Staff Standards (current edition)

•  NCQA, Credentialing Standards (2024 update)

•  CompHealth/AAPPR credentialing survey data

•  Merritt Hawkins, Physician Revenue Survey (2019)

•  AMN Healthcare, The Cost of a Physician Vacancy

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