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Avoid pitfalls common to the initial appointment and reappointment phases

Credentialing & Verification Update, February 27, 2008

A review of case law nationwide reveals a number of common credentialing pitfalls that, if avoided, can shield hospitals from liability. Below, we break down these pitfalls into those that typically occur during initial appointment and those common to the reappointment phase.

Common pitfalls during initial appointment include failing to:

• Require applicants to submit complete applications
• Verify application information. Interestingly, most verification failures aren't intentional. Instead, credentialing staff are overburdened or, more often, hospitals fail to identify verification duties in their bylaws or policies/procedures documents.
• Follow up on red flags
• Demand information that an applicant has either refused to provide or simply failed to provide

Common pitfalls during reappointment include failing to:

• Request and follow up on information from the National Practitioner Data Bank
• Follow up on red flags (Although this is usually much more of a problem during initial appointment, it can also be problematic for reappointments.)
• Attach the entire credentials file, which would allow each committee member to thoroughly review the completed application and all supporting documents. Providing a summary sheet of physicians' credentials is not enough.

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