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Creating a credentials review summary form

Credentialing & Verification Update, January 31, 2007

A credentials review summary allows medical staff professionals to document the numerous checks that medical staff and administrative leaders perform on an application. Reviewers use the form to identify their findings and to sign off on the information.

In cases where one or more medical staff leaders is unable to make a positive finding or recommendation, the entire file-along with the medical executive committee's findings and recommendations-will be processed according to the medical staff bylaws.

The credentials review form will be presented to the board or the board's subcommittee prior to formal board action concerning requests for appointment, reappointment, or clinical privileges.

Examples of the "reviews and attestations" that should be documented on the form include the following:

• License is current and unrestricted
• DEA is current and unrestricted
• No prior criminal record identified
• NPDB report reviewed; no issues identified suggesting competency problems
• Basic medical/other education record reviewed and found normal
• Residency training reviewed; no problematic issues of any kind identified
• Board status reviewed; no problematic issues of any significance identified
• Information from prior clinical practice settings reviewed; nothing identified suggesting problems with clinical practice, behavior, or adherence to medical staff rules identified

To learn more about creating a credentials review summary or to download a free sample, click here.

To sign up for a Free Trial of CPDR, click here.

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