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Disclosing reference information

Credentialing Resource Center Connection, February 21, 2008

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Sally J. Pelletier, CPMSM, CPCS, is a consultant with The Greeley Company, a division of HCPro, Inc., specializing in the areas of credentialing and privileging.

Dear credentialing colleague:

I enjoyed seeing those of you who attended the NAMSS Leadership Council in Palm Springs this past week. Thank you for your dedication to the medical services profession.

Previous columns have addressed the issue of references for both initial applicants and reapplicants in terms of the type of form organizations can use to gather information, and from whom they should collect those references. But how should physician leaders and MSPs respond when they are asked to share information about references with the applicant? Should the references that your organization has obtained be kept confidential? Or, does the applicant have the right to view the references within his or her credentials file and, if so, under what circumstances?

I can almost hear the collective answer from readers this week: Follow the 5 P's. What is the policy? 

The majority of organizations seem to agree that, for the most part, references are held in confidence to protect the person providing the reference and to allow that person to have absolute candor in his or her response. Therefore, if an organization follows this policy, then it would not routinely share references with the applicant. References would only be shared with individuals, per the policy, on a "need to know" basis. Such individuals may include medical staff leaders, the medical staff services department, senior management, and the governing board.

Certain circumstances may dictate that an organization discloses reference information. In light of this, your organization should make this possibility known to all potential references to avoid misunderstandings. For example, such a disclosure situation may arise if an applicant is undergoing a fair hearing process and facing potential restriction or termination of clinical privileges. Your organization's policy should address circumstances in which it may disclose information contained within references. Just as we all would want the right to know about negative information in our personnel files, physicians should also have a right to know about information upon which a negative decision could be based. In addition, it is best practice to develop this policy with advice obtained from your hospital legal counsel that addresses your specific state statutes applicable to peer review and discoverability.

Remember, credentialing has no other master than the patient.

That's all for this week.

All the best,

Sally J. Pelletier, CPMSM, CPCS
http://www.greeley.com/consulting.cfm

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