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No exceptions to this rule

Credentialing Resource Center Connection, April 27, 2004

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Dear Credentialing Colleague:

Occasionally, medical staff professionals and credentialing specialists experience difficulty obtaining information about practitioners. Remember, the burden lies with the applicant to produce the necessary and requested information for an organization.

No hospital or managed care organization should appoint a practitioner or grant privileges to a practitioner until it receives, verifies, and evaluates all required information.

Your organization should develop a policy that requires that a practitioner who either applies for or maintains medical staff membership and/or privileges must provide the evidence that demonstrates, in the sole discretion of the hospital, that he or she meets the hospital's established criteria for membership and privileges. This policy would apply at the time of initial appointment, reappointment, application for clinical privileges, employment, or at any time during a practitioner's affiliation with the institution.

There are no exceptions to this rule. There may be cases when references fail to respond, or prior organizations fail to confirm affiliations, provide disciplinary information, or provide needed peer review information. Under these circumstances, the institution should send an appropriately drafted business letter to the practitioner informing him or her of the organization's policy.

The letter should also notify the practitioner that the medical staff will terminate the application process if it does not receive the required information.

For sample policies and letters that address this challenge, check out HCPro's "The Complete Medical Staff Office Manual."

That's all for this week.

All the best,

Hugh Greeley

http://www.greeley.com/seminars/

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