How to audit credentialing and privileging practices
Healthcare Auditing Weekly, November 15, 2005
This week, we'll conclude our discussion of auditing your organization's credentialing and privileging practices.
After you've determined whether your facility's credentialing office verifies key information in new physician applicants, establish whether the organization uses the following best practices. Ensure that
bylaws provide for an expedited process so the organization can quickly recommend and approve excellent candidates for medical staff appointment and reappointment
criminal background checks are performed on all applicants
the verification process includes primary source verification of professional liability history and query for Medicare/Medicaid fraud
the appointment application includes a statement regarding the percent of continuing medical education that relates to the privileges the physician has requested
The above tip is an excerpt from the book "Hospital Auditing and Monitoring: Sample Programs for Key Risk Areas." Copyright 2004 by HCPro, Inc. This book is a step-by-step, practical manual that offers sample audit programs for the most troublesome areas that a hospital must audit. The binder and CD-ROM are filled with actual audit programs used by auditors and compliance officers in the field. Click here for more information or to order your copy today.
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