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Summarizing credentials files in preparation for review

Credentialing & Verification Update, June 20, 2007

After MSPs receive and verify all required information for an applicant, they must assemble the results of their work to present the complete credentials file and a summary of its contents to the appropriate committees and/or individuals for review. At this point, the CEO should send a letter to the applicant informing him or her that the application is entering the review stage.

It is essential that MSPs present only completed credentials files for review. Unfortunately, administrative personnel often are compelled to take a credentials file to reviewers-such as department chairs or credentials committee members-when it is incomplete. In some cases the hospital may not have received references or information pertaining to past clinical activity or malpractice cases, or the hospital may not yet have verified all of the practitioner's credentials.

Likewise, many reviewers are compelled to make a recommendation regarding appointment even if the file does not contain sufficient information. Often, reviewers give some applicants the benefit of the doubt, assuming that the hospital will receive the missing information and that the information will be sufficient. Meanwhile, this "benefit of the doubt" is withheld from other applicants. All of these practices leave the MSO, and the hospital, open to liability, however.

Note: If the MSO finds discrepancies between information provided on the application and the responses of references (particularly oral responses) or information obtained from the National Practitioner Data Bank or state licensing boards, the clinical interview should take place before the MSO forwards the application to the department chair. The interview can help clarify questions or concerns about the applicant's experience, education, or other facets of his or her practice.

Editor's note: Subscribers to CPDR have access to various forms that aid them in performing credentialing and verification tasks. If you are not yet a CPDR subscriber and would like to sign up for a free 30-day trial, click here.

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