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Credentialing & Verification Update

Issue 26, December 19, 2007

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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

• 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...