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Final clinical evaluations

Credentialing Resource Center Connection, July 17, 2008

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Anne Roberts, CPMSM, CPCS, is the director of medical affairs at Children's Medical Center of Dallas, where she oversees the medical administration, graduate medical education, and medical staff services departments.

Dear credentialing colleague:

A few weeks ago during HCPro’s webinair’s “Kadlec Reversed: How to Collect and Share Credentialing Data While Avoiding Legal Risk,” one of the speakers mentioned the concept of  “forever more” verifications. I thought this was great idea and had one of our credentialing coordinators research and develop this new process internally at our organization.

A final clinical evaluation or a “forever more” verification, is a clinical evaluation that is completed by the current department chief when a medical staff member resigns. This clinical evaluation also includes the practitioner’s dates of affiliation, department, and specialty. The intent behind “forever more” verifications is to document this information for future reference and potentially share it with other organizations who request information about the practitioner.

Credentialing best practices already include verifying all education, training, and experience from the date a practitioner graduated through the date of application. When MSPs verify hospital affiliations where the practitioner resigned privileges several years ago—sometimes as many as 20 years ago—the MSP may only get a response indicating the dates that the individuals practiced or held privileges at the organization. Many times no one knows the individual personally and therefore the only information available is the basic dates and department information. Having the department chief complete a clinical evaluation at the time the individual resigns will forever document the evaluation of the practitioner’s performance at your organization.

For low-volume providers the department chief can’t evaluate personally, we are developing a standard response specific to our organization. It will include a summary from the chief that indicates the practitioner’s volume was low and whether or not any level of personal evaluation is available. Information, such as compliance with rules (medical record completion, hospital rules and policies) and other rule indicators, will be summarized and the clinical evaluation will state, as applicable: not available due to low volume.

Although we are still working out all of the details and drafting communication to the department chiefs regarding our goals for this new process, I wanted to share the concept with you for consideration at your organizations.

Remember, clear, effective communication is the key to success!

That's all for this week.

All the best,

Anne Roberts, CPMSM, CPCS

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