How to audit credentialing and privileging practices
Healthcare Auditing Weekly, October 25, 2005
Today, we'll continue our discussion of auditing your organization's credentialing and privileging practices. After reviewing relevant documents and medical staff bylaws, develop a checklist of data that the medical staff's office (MSO) personnel collect and verify when physicians apply for or renew their affiliation with the organization.
Include the following:
Date of request for application
Date application was received
Dates of any and all correspondence with applicant
Copy of medical license
Drug Enforcement Agency (DEA) certificate (state and federal)
Medical/professional school, residency, and fellowship training
Board certification
Malpractice coverage/history
Other affiliated organizations
Military service (if applicable)
National Practitioner Data Bank query and receipt of report
American Medical Association Physician Masterfile report
Any sanction information and explanations
Date Office of Inspector General sanction report is queried
Peer references
Criminal background check (if used)
Next week, we'll continue with a discussion of choosing a sample of credentialing files to review.
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