Credentialing & Privileging

Ask the expert: How can our credentials committee make objective decisions regarding low- and no- volume practitioners when often times the practitioner is a colleague that committee members have known for years?

Credentialing Resource Center Insider, April 6, 2012

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Credentials committees often overanalyze credentialing and privileging decisions regarding low- and no-volume providers in an attempt to avoid insulting or criticizing a colleague. However, the best course of action is to approach every applicant in a businesslike manner. Rely on your policies and procedures to avoid the appearance of impropriety, and communicate with low- or no-volume practitioner regarding:

  • Established criteria for clinical privileges, including whether your facility requires a minimum number of patient contacts per year
  • The physician’s plan to grow or narrow his or her practice
  • The hospital’s increased focus on determining proficiency for clinical privileges
  • Your medical staff’s strategic direction
  • Volumes incurred at your facility

This week’s question and answer are from Assessing the Competency of Low-Volume Practitioners: Tools and Strategies for OPPE and FPPE Compliance by Mark A. Smith, MD, MBA, CMSL, and Sally Pelletier, CPMSM, CPCS.



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