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Credentialing & Verification Update
Credentialing & Verification Update
Issue 26, December 19, 2007
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State-to-state licensure agreements: Endorsement and reciprocity
Most healthcare professionals are regulated through the licensure process or through testing or... -
Reader tip for protecting practitioners’ identities during verification
In the November 21st issue of CVU, we published "Guidelines for querying schools, colleges, and... -
Q&A: Where on the Internet, besides the NPDB site, can I conduct background checks on nurse practitioners?
A: Nurse practitioners (NPs) must have licensure verified with the individual state in which they...
Issue 25, December 5, 2007
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Advantages of criteria-based core privileging
The criteria-based core privileging approach is an efficient and effective approach to privileging... -
No shortage of flu vaccine expected this season
Healthcare facilities and physicians nationwide are finding that supplies of the flu vaccine this... -
Q&A: Our hospital filled a nursing director position (which requires a BS in nursing
A: If the individual you describe is in an administrative nursing director role only and is not...
Issue 24, November 21, 2007
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Guidelines for querying schools, colleges, and educational programs
There are some general procedures that might help expedite verifications and ensure that they are... -
Joint Commission and AHRQ release special report
The Agency for Healthcare Research and Quality (AHRQ) and The Joint Commission released findings... -
Q&A: According to the Joint Commission, is verification of DEA certificate mandatory?
A: With regard to Drug Enforcement Agency (DEA) certificates, The Joint Commission standards state...
Issue 23, November 7, 2007
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Changes in healthcare affecting AHP credentialing, Part 3
Note: This is the third entry in a multi-part series focusing on changes in healthcare that are... -
Tips for new CPDR online users
The Credentialing and Privileging Desktop Reference (CPDR) is an interactive and searchable tool... -
Q&A: Which states have ruled on negligent credentialing claims?
A: Courts in at least 28 states have addressed negligent credentialing claims. Here is a breakdown...
Issue 22, October 24, 2007
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Changes in healthcare that affect AHP credentialing, Part 2: State statutes
Note: In the last issue, we began a multi-part series focusing on changes in healthcare that are...
Issue 21, October 10, 2007
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Recognizing changes in healthcare that affect AHP credentialing, Part 1
MSPs continually identify the credentialing of allied health professionals (AHP) as one of their... -
Q&A: I’m aware that I must query primary source hospital affiliation, but must I verify all practice experience and clinics. How far back must I go?
A: Each hospital must decide how far back to go in verifying past affiliations. While some verify...
Issue 20, September 26, 2007
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Joint Commission: Ensure that information from CVOs is complete, accurate, and timely
The Joint Commission states that hospitals that use information from a CVO should be confident that... -
Q&A: Should I "google" medical staff applicants to find additional information about them?
A: Entering the applicant’s name into a search engine such as Google (www.Google.com) can... -
Is your facility missing from CPDR?
If your healthcare organization is not yet listed on CPDR online, we want to know about it!
Issue 19, September 12, 2007
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Tips for orienting new medical staff members
In the last issue of CVU, we discussed the importance of having an orientation for physicians on... -
Q&A: Should physicians' quality data be kept in the credentials file?
A: It has been the practice to separate credentials files and quality documents, for two primary... -
CMS ceases payments for hospitals' mistakes
The Centers for Medicare & Medicaid Services (CMS) will stop paying hospitals for the costs of...
Issue 17, August 15, 2007
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Hospital found negligent in privileging physician
A jury found Putnam General Hospital in Hurricane, WV, negligent in privileging a physician who was... -
Credentialing concerns after the initial application: orientation
Once you have completed the preliminary credentialing process with an applicant and your... -
Is there a simple method for verifying malpractice insurance claims history?
A: An individual query to the professional liability carrier(s) is the only way to verify...
Issue 16, August 1, 2007
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Obtaining useful references
Gathering physicians’ references is an essential part of the credentialing process, but it... -
Q&A: How can I ensure that I and my fellow MSPs are recognized for the many task
A: One way to make sure that you are recognized for your accomplishments throughout the year is to... -
Access a free clinical privileges activity review form
Subscribers to the 2007 Credentialing and Privileging Desktop Reference (CPDR)-and readers who sign...
Issue 15, July 18, 2007
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Benefits of using a credentialing verification organization
Hospitals have a number of opportunities to involve a credentialing verification organization (CVO... -
Q&A: What does The Joint Commission say about decision notification to applicant
A: The Joint Commission states that practitioners should be informed of the decision to grant... -
U.S. News & World Report releases list of best American hospitals 2007
U.S. News & World Report has published its annual list of America's best hospitals (available at...
Issue 14, July 4, 2007
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Q&A: Does CMS differ from The Joint Commission in stating which practitioners ca
A: The conditions of participation say a restraint can be ordered by a physician or licensed... -
Suggested questions to ask applicants in the clinical interview
An application for appointment to the medical staff and/or clinical privileges has four main phases...
Issue 13, June 20, 2007
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Summarizing credentials files in preparation for review
After MSPs receive and verify all required information for an applicant, they must assemble the... -
Q&A: Which items on an application need primary source verification?
A: Verify the following pieces of information by contacting their sources (or issuers):
Issue 12, June 6, 2007
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The pros and cons of various primary source verification methods
Medical staff professionals (MSPs) use various modes of communication-including telephone, fax... -
Q&A: What must a hospital do to allow a practitioner other than a physician to p
A: A physician, an oral maxillofacial surgeon, or other qualified individual, in accordance with...
Issue 11, May 23, 2007
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The nuts and bolts of querying the National Practitioner Data Bank
The nature of National Practitioner Data Bank (NPDB) report-triggering events varies depending on... -
Fast facts for credentialing specialists: Did you know...
Did you know that 5% of The Joint Commision standards yield approximately
Issue 10, February 28, 2007
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Q&A: What are the managed care equivalents to hospital titles commonly encounter
A: Often, the titles of boards, committees, or staff with nearly identical roles at a managed care... -
Three key steps to verification during reappointment
Accreditation and licensing standards require a reappointment component to physician privileging... -
Q&A: Is it acceptable to use a stamp for the MEC chair’s signature on delineatio
A: There are several issues to consider. First, confirm that state law does not prohibit the use of... -
Patients gave hospitals higher marks in 2006
Patient satisfaction with the nation’s hospitals increased in 2006, according to a survey... -
Tips for developing a system of conducting background checks
If your facility believes that conducting criminal background checks is important but is worried...
Issue 9, April 25, 2007
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Checking applications during reappointment
Requiring applicants to complete applications for reappointment is a crucial step in satisfying the... -
Q&A: Is a physician entitled to a fair hearing when his or her privileges are no
Q&A: Is a physician entitled to a fair hearing when his or her privileges are not renewed at... -
Follow-up: Tips for dealing with practitioners who won't take credentialing seri
In response to a reader question, the April 11 issue of CVU offered three tips for medical staff...
Issue 8, April 11, 2007
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Perform credentialing audits to monitor compliance and check outcomes
Perform credentialing audits to monitor compliance with various processes involved in credentialing... -
Q&A: What tips can you provide for dealing with physicians who don’t take the cr
A: This is a common question among medical staff professionals (MSPs), who often deal with... -
Q&A: What tips can you provide for dealing with physicians who don’t take the cr
A: This is a common question among medical staff professionals (MSPs), who often deal with... -
Perform credentialing audits to monitor compliance and check outcomes
Perform credentialing audits to monitor compliance with various processes involved in credentialing...
Issue 7, March 28, 2007
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Verifying employment/appointment history: Determining how far back is far enough
Discuss the topic of verifying employment/appointment history-and in particular the topic of how... -
Q&A: What criteria, is appropriate to evaluate when credentialing a physician?
A: The processes for credentialing and privileging should be clearly outlined in the medical staff...
Issue 6, March 14, 2007
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When space is a premium: Strategies for maintaining and storing credentials file
Most credentials files contain large amounts of material (e.g., letters received thanking... -
Q&A: Does The Joint Commission require individual practitioners to have malpract
Q&A: Does The Joint Commission require individual practitioners to have malpractice insurance?
Issue 5, February 14, 2007
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Q&A: To what extent can the hospital inquire about a medical staff applicant’s h
A: Hospitals have the right, and the obligation, to ask medical staff applicants about their health... -
More on verifying a practitioner’s military credentials
After the January 31 edition’s Q&A on how to verify practitioners’ military credentials... -
Sign up for a free trial of CPDR and access a free professional reference questi
Subscribers to the 2007 Credentialing and Privileging Desktop Reference (CPDR)-and readers who sign...
Issue 4, January 31, 2007
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Creating a credentials review summary form
A credentials review summary allows medical staff professionals to document the numerous checks... -
Q&A: How do I verify a practitioner’s military credentials?
Many factors can complicate efforts to verify the credentials of a practitioner who trained or...
Issue 2, January 17, 2007
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Q&A: Can you list some favorite credentialing Websites from fellow MSPs?
A: Absolutely! The following are just a sampling of the sites that medical staff professionals... -
Tailor professional reference questionnaires
The Joint Commission’s 2007 prepublication standards show that the accreditor is paying more...
Issue 1, January 3, 2007
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Tips for new CPDR online users
The newly redesigned 2007 Credentialing and Privileging Desktop Reference (CPDR) is an interactive... -
Q&A: What is fast-track credentialing?
A: There are two common credentialing systems: the traditional system and the fast-track system...