Hospital Privileges: What They Are & Why They Matter

If you’ve ever dealt with credentialing providers, you’ve probably heard the term hospital privileges—but what does it actually mean? More importantly, do all doctors still need them today? Let’s break down what hospital privileges are, the different types, and how they impact insurance credentialing and provider requirements.

Key Takeaways

Hospital privileges grant doctors permission to admit patients, perform procedures, or consult at a hospital.
There are three main types: Admitting, Courtesy, and Surgical privileges.
Not all doctors need them—hospitalists now handle inpatient care, but surgeons and OB/GYNs still require privileges.
The application process is lengthy (60-180 days) and involves credentialing, background checks, and hospital review.
Common pitfalls include missing paperwork, slow reference responses, and malpractice history.
Privileges require renewal every 2 years, and missing deadlines may mean reapplying from scratch.
Hospital privileges ≠ insurance credentialing, so providers must complete both separately.

What Are Hospital Privileges?

Simply put, hospital privileges are permissions granted to a healthcare provider by a hospital, allowing them to admit patients, perform procedures, or consult on cases within that facility. These privileges used to be a much bigger deal back when outpatient doctors would follow their patients into the hospital.

However, the rise of hospitalists—doctors who work exclusively in hospitals—has shifted the landscape. Nowadays, many outpatient providers no longer need hospital privileges, but there are still situations where they’re required.

Insurance companies might mandate them for network participation, and certain specialties (like OB/GYN or surgery) still rely on them to perform procedures or admit patients directly.

The Three Main Types of Hospital Privileges

Different hospitals may have their own classification system, but generally speaking, there are three major types of hospital privileges:

1. Admitting Privileges

This type of hospital privilege allows a provider to admit patients directly to the hospital without sending them through the emergency room first.

For example, let’s say a primary care physician sees a patient in their office who has severe dehydration and needs IV fluids. If that provider has admitting privileges, they can bypass the ER and send the patient straight to a hospital bed.

2. Courtesy Privileges

This is a lighter version of admitting privileges. While a provider with courtesy privileges might still occasionally admit a patient directly, it’s not their primary function.

Instead, courtesy privileges allow a doctor to:

Visit their patients in the hospital
Communicate with hospital doctors about their care
Place orders or check in on treatment plans

Some insurance companies require at least courtesy privileges for certain specialties, even if the doctor never actually admits patients directly.

3. Surgical Privileges

For surgeons, OB/GYNs, and other specialists who perform procedures, surgical privileges are crucial. This allows them to use the hospital’s operating rooms and surgical facilities.

Some providers might also need surgical privileges at ambulatory surgery centers (ASCs), which are outpatient facilities separate from hospitals.

How to Apply for Hospital Privileges (And What to Expect)

So now that we’ve covered what hospital privileges are and the different types, let’s get into the real work—applying for them. If you’re a provider (or handling credentialing for one), you’ll quickly find that securing hospital privileges is no joke. It’s time-consuming, tedious, and sometimes expensive.

But don’t worry—I’m breaking it all down so you know exactly what to expect before diving in.

Applying for Hospital Privileges: Where to Start?

The first step in securing hospital privileges is choosing the right hospital(s). Most providers will apply for privileges at a hospital where they expect to send or treat their patients.

For example:

A general surgeon may apply for privileges at a large hospital with an OR and an ambulatory surgical center.
An OB/GYN will likely need privileges at a hospital with a labor and delivery unit.
A primary care physician may only need courtesy or admitting privileges at a nearby hospital.

Once a provider chooses the hospital, they’ll need to start the credentialing process.

The Credentialing Process for Hospital Privileges

Step 1: Submit an Application

Every hospital has its own medical staff office that handles privileges and credentialing. They’ll require an application that typically asks for:

Medical license information
Board certifications
Malpractice insurance details
Past work history
Educational background (med school, residency, fellowship, etc.)
References from other providers
A detailed list of procedures the provider wants to perform (if applying for surgical privileges)

Many hospitals require providers to apply through CAQH (Council for Affordable Quality Healthcare), which is a universal database used for credentialing.

Step 2: Hospital Review & Verification

After the application is submitted, the hospital will verify everything. This can take weeks or even months, depending on:

How quickly the provider submits documents
How responsive past employers and references are
Whether the provider has any malpractice claims or disciplinary actions

A hospital credentialing committee will review the application, check for red flags, and determine if the provider meets their standards.

If you’re navigating the complexities of hospital privileges, you’ll also need to understand the credentialing process—a critical step for providers looking to work with hospitals and insurance networks.

Credentialing ensures that a provider meets all licensing, education, and background requirements before being granted privileges or in-network status. For a detailed breakdown of the essential steps in credentialing, check out this guide: Essential Steps in the Credentialing Process.

Whether you’re applying for hospital privileges or just getting started with insurance credentialing, this resource will walk you through what to expect and how to avoid common delays.

How Long Does It Take to Get Hospital Privileges?

Expect hospital privileges to take anywhere from 60 to 180 days to be fully approved. This process is usually slower than standard insurance credentialing because hospitals do an extensive background check before granting privileges.

A few things can delay the process:

Reason for Delay	How to Prevent It
Missing documents	Double-check the hospital’s checklist before submitting your application.
Slow reference responses	Notify your references in advance so they can respond quickly.
Malpractice history	If you have past claims, be upfront about them and provide explanations.
Hospital board schedules	Some hospitals only review applications once a month.

If a provider urgently needs hospital privileges, they can sometimes request temporary or emergency privileges, but these are granted on a case-by-case basis.

The Cost of Hospital Privileges

Hospital privileges aren’t always free. Many hospitals charge an application fee, and some require ongoing membership dues for the medical staff.

Other potential costs include:

Malpractice insurance coverage that meets the hospital’s requirements
Annual or biennial renewal fees
Additional training or compliance requirements (like taking hospital-specific courses)

Some hospitals also require providers to take call shifts or agree to see ER patients as part of their privileges. This can be a deal-breaker for providers who don’t want extra responsibilities.

Renewing & Maintaining Hospital Privileges

Once a provider secures hospital privileges, they’ll need to renew them regularly—usually every two years (except in Illinois, where some hospitals allow a three-year cycle).

Renewal requires:

Updated credentialing paperwork
Proof of continued education (CME credits)
Verification that the provider has been actively using their privileges

If a provider hasn’t been admitting patients or using the hospital facilities, the hospital might not renew their privileges.

Are Hospital Privileges Worth It?

For some providers, hospital privileges are essential. For others, they’re more hassle than they’re worth. Many outpatient doctors today skip hospital privileges altogether, relying on hospitalists to care for their patients during hospital stays.

But for surgeons, OB/GYNs, and other specialists, hospital privileges are non-negotiable. Without them, they simply can’t perform procedures.

Before applying, providers should consider the time, cost, and requirements and decide if hospital privileges align with their practice goals.

Common Pitfalls in Getting Hospital Privileges (And How to Avoid Them)

By now, you know that hospital privileges aren’t exactly a quick and easy process. Between extensive paperwork, long approval times, and hidden costs, it’s easy to run into delays or outright denials.

So let’s talk about the most common pitfalls providers face when applying for hospital privileges—and, more importantly, how to avoid them.

Pitfall #1: Incomplete or Incorrect Applications

One of the biggest reasons for delays in getting hospital privileges is missing or incorrect information on the application.

How to Avoid It:

Double-check all paperwork before submitting.
Use a checklist (most hospitals provide one) to ensure everything is included.
Follow up with the medical staff office to confirm they received all required documents.

Even a small mistake—like a missing date on a malpractice insurance certificate—can push your application to the back of the line.

Pitfall #2: Slow Response from References or Past Employers

Hospitals require professional references and verification of past employment. If these contacts are slow to respond, your application stalls.

How to Avoid It:

Notify your references ahead of time so they expect the request.
If the hospital allows, provide multiple references in case one doesn’t respond.
Follow up with past employers to ensure they complete the verification quickly.

If a reference or employer doesn’t respond within 30–60 days, the hospital won’t move forward with your application.

Pitfall #3: Malpractice History or Disciplinary Actions

Hospitals do a deep background check. If a provider has malpractice claims, license suspensions, or disciplinary actions, they might face extra scrutiny or even get denied.

How to Avoid It:

Be upfront about any malpractice history—don’t try to hide it.
Provide written explanations for past claims and steps taken to prevent future issues.
If possible, submit strong references who can vouch for your competency and ethics.

Having a malpractice case doesn’t automatically mean denial, but failing to disclose it definitely will.

Pitfall #4: Not Meeting Hospital-Specific Requirements

Each hospital has its own unique rules for granting privileges. Some might require:

Specific malpractice insurance coverage levels
Additional training or certifications
Participation in on-call rotations
A minimum number of admissions or procedures per year

How to Avoid It:

Read the hospital’s credentialing requirements carefully before applying.
If your malpractice insurance doesn’t meet their standards, work with your provider to adjust coverage.
Make sure you’re comfortable with any required call schedules or commitments.

Many providers drop their application halfway through after realizing the hospital’s requirements aren’t worth it. Do your homework before applying!

Pitfall #5: Taking Too Long to Start the Process

Getting hospital privileges can take 3 to 6 months (sometimes longer). If a provider waits too long to apply, they might miss out on seeing patients or performing surgeries.

How to Avoid It:

Start the application process at least 6 months before privileges are needed.
If the hospital allows it, apply for temporary privileges while waiting for full approval.
Work with a credentialing expert to speed up the process.

Waiting until the last minute = big mistake. Many providers have had to delay surgeries or turn away patients because they weren’t approved in time.

Pitfall #6: Assuming Privileges = Automatic Insurance Credentialing

Even if a provider gets hospital privileges, that doesn’t mean they’re automatically credentialed with insurance companies.

Some hospitals offer their own insurance plans and require providers to be in-network before granting privileges. Others might have no connection to insurance credentialing at all.

How to Avoid It:

Check if the hospital requires insurance credentialing before applying for privileges.
Work on both hospital and insurance credentialing at the same time to avoid delays.
If the hospital requires in-network status, start the insurance credentialing process early.

In states like Oregon, large hospital groups like Providence and Legacy require providers to be credentialed with their insurance plans before granting privileges. If you don’t plan ahead, you could be stuck waiting months just to get in-network.

Pitfall #7: Not Keeping Up with Renewal Deadlines

Once a provider gets hospital privileges, they have to renew them regularly—usually every 2 years. If they miss the renewal deadline, they might have to restart the entire credentialing process.

How to Avoid It:

Mark renewal deadlines on your calendar or set reminders.
Keep all documents updated so you’re ready when it’s time to renew.
Stay in touch with the hospital’s credentialing office to ensure you meet all ongoing requirements.

Losing hospital privileges because of a missed renewal is beyond frustrating—and totally avoidable.

Hospital Privileges FAQ: Everything You Need to Know

What are hospital privileges?

Hospital privileges are the formal permissions granted by a hospital that allow a provider to admit patients, perform procedures, or consult on cases within that facility.

Do all doctors need hospital privileges?

No. Many outpatient providers, especially primary care doctors, no longer need hospital privileges because hospitalists now handle inpatient care. However, surgeons, OB/GYNs, and some specialists still require hospital privileges to perform procedures.

What are the different types of hospital privileges?

The three main types of hospital privileges are admitting privileges, courtesy privileges, and surgical privileges. Each type determines how involved a provider can be in hospital-based care.

How long does it take to get hospital privileges?

The process can take 60 to 180 days, depending on the hospital’s review process, how quickly references respond, and whether there are any delays in verifying credentials.

Can you get temporary hospital privileges?

Some hospitals offer temporary privileges if a provider needs to start working before full approval. However, this is usually granted on a case-by-case basis and often requires proof of urgent need.

Is hospital credentialing the same as insurance credentialing?

No. Getting hospital privileges does not mean a provider is credentialed with insurance companies. Some hospitals require providers to be in-network with their insurance plan before granting privileges, but the two processes are separate.

How often do hospital privileges need to be renewed?

Most hospitals require providers to renew privileges every two years. In some states, like Illinois, renewal can be every three years, but this varies by hospital.

Do you have to pay for hospital privileges?

Yes, in most cases. Hospitals may charge an application fee, annual dues, and require providers to have malpractice insurance that meets their standards. Some hospitals also require providers to take call shifts as part of their privileges.

Can hospital privileges be denied?

Yes. A hospital may deny privileges due to malpractice history, incomplete applications, failure to meet hospital requirements, or issues with references. They may also refuse privileges if the provider doesn’t have an active patient base that requires hospital services.

What happens if hospital privileges expire?

If a provider misses the renewal deadline, they may have to restart the entire application process. Some hospitals offer grace periods, but others require a full re-credentialing process.

How can I speed up the hospital credentialing process?

Double-check that the application is complete and accurate, notify references in advance, ensure malpractice coverage meets hospital requirements, and follow up with the medical staff office regularly to avoid unnecessary delays.

Final Thoughts: Be Prepared, Stay Proactive

Getting hospital privileges is a long, tedious process, but avoiding common mistakes can make things much smoother.

✅ Double-check applications for accuracy
✅ Notify references in advance
✅ Disclose malpractice history upfront
✅ Understand the hospital’s requirements before applying
✅ Start early—hospital credentialing takes time
✅ Don’t assume privileges = insurance credentialing
✅ Stay on top of renewal deadlines

By staying proactive and organized, you can avoid delays, denials, and unnecessary stress.