Credentialing & Privileging

Obtaining useful references

Credentialing & Verification Update, December 27, 2006

Gathering physicians' references is an essential part of the credentialing process, but it can also be one of the most difficult. In addition to the challenges that you may face when trying to obtain timely references, hospital administration may pressure you to move the credentialing process along before you have all of the necessary information.

Although the challenge may seem daunting at times, don't succumb to frustration or external pressure, advises Sally J. Pelletier, CPMSM, CPCS, a consultant with The Greeley Company, a division of HCPro, Inc.

"[Credentialing] can be like pulling teeth, but that doesn't relieve the facility from its obligation to protect the patient," Pelletier says. "The hospital really needs to do due diligence to protect it from a negligent credentialing suit." Pelletier recommends taking the following steps to ensure that you obtain the most appropriate and useful references:

  • Contact references directly. This will help to ensure that you receive honest, reliable information, as compared with allowing your candidates to bring you prepared letters from their references.
  • Prepare a reference questionnaire. Create a list of questions to use in eliciting data from references that you believe are essential to credentialing the applicant.
  • Find a current reference. Contact someone who has observed the candidate within the past 12 months, and can therefore attest to his or her current clinical competence.
  • Follow up on nonresponses. If you believe that you're contacting the right references but are not receiving responses, don't abandon these people too quickly. Sometimes a nonresponse can be a red flag, says Pelletier. Reasons for a nonresponse can vary widely: Are they not responding because they don't have anything good to say, or did they not receive the request, or are they too busy?
  • Place the burden on the applicant. If you're not getting responses from references, put pressure on the applicant to facilitate the request. A candidate's involvement may help overcome communication hurdles.
  • Educate your administration. Obtaining references often takes time, but your administration may pressure you to move the credentialing process forward without a complete information packet. If you face this pressure, consider educating your administration on the risks involved in moving forward without the appropriate information (e.g., credentialing lawsuits and potential health risks to your patients).

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