Credentialing & Privileging

Featured blog post: Peer chart review form

Credentialing Resource Center Connection, February 25, 2011

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Linda Van Winkle, CPMSM, CPCS, manager of medical staff services at Christus St. Patrick Hospital in Lake Charles, LA, sent in this form for peer case review.

Linda writes:

The tool can be modified to adapt it to the peer review indicators various hospitals use, as well as the conclusions the individual hospital uses regarding a specific case. The top third of the form is completed by the individual/department that refers the case for review, or in some cases, I fill in that top third.  Pertinent information (notes from a case manager, a copy of a portion of the record that contains illegible handwriting, etc.) is stapled to this form.  The packet of info is clipped to the medical record so that when the peer reviewer comes in to review the case, everything is there.

The peer review[er] completes the middle third of the form.

The sheet is then brought to the peer review committee, at which time the final portion of the form is completed (is more information needed from the attending physician? Do need a second peer to review this case? etc.), and the information is then entered into our spreadsheet for tracking/trending/follow-up action.

The form has worked very well for us.  Our physicians are familiar with it because it’s been around awhile and is always attached to the medical records they are being asked to review.

Download the form and many others that MSPs just like you have submitted to the Credentialing Resource Center Symposium contest at www.CredentialingResourceCenter.com/blog.



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