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Credentialing & Verification Update

Issue 39, December 30, 2008

• Happy New Year from HCPro!

  Today, New Year's Eve, we remember the year that has past and preapre for new...

• California inconsistent with healthcare licensee background checks

  Tens of thousands of California healthcare workers, including physicians, dentists, physiologists...

• Q&A: Must you query the NPDB on interns, residents, and fellows?

  No. Healthcare entities are not required to query the National Practitioner Data Bank (NPDB) on...

Issue 38, December 23, 2008

• Rhode Island Department of Health announces electronic licensure verification

  The Rhode Island Department of Health announced that effective January 1, 2009, it will no longer...

• Zagat ranks physicians for insurers

  Blue Cross and Blue Shield has announced it will make physician rankings provided by dining guide...

• From the CRC Blog: Is the NPDB’s Proactive Disclosure Service for you?

  I’ve been considering signing up for the Proactive Disclosure Service (PDS) but thought...

Issue 37, December 15, 2008

• Q&A: What information is contained within the Healthcare Integrity and Protection Data Bank (HIPDB)?

  The HIPDB is a data collection program for the reporting and disclosure of certain final adverse...

• Is your facility listed correctly in the CPDR online?

  Help your fellow medical staff professionals; ensure your facility is listed in the Credentialing...

• Locate state-by-state medical licensure requirements

  Need to know the specific requirements of the state medical boards of Montana, California, or...

Issue 36, December 9, 2008

• FSMB to provide residency verification for closed programs

  The Federation of State Medical Boards (FSMB) has announced it will permanently store the physician...

• Q&A: Can I verify osteopathic physicians' (DO) credentials online?

  Yes. The American Osteopathic Association (AOA) provides online credentials verification profiles...

• Download a free crosswalk comparing 2004 and 2008 CoP medical staff standards

  To help medical staff professionals better understand the 2008 updates to the Centers for Medicare...

Issue 35, December 2, 2008

• The 2009 Credentials Verification Desk Reference (CVDR) is now available

  The 2009 Credentials Verification Desk Reference (CVDR) is now available; order your copy...

• Former hospital employee admits to selling celeb records

  Another hospital employee is in trouble for breaching patient confidentiality. A former...

• New York Times publishes report on disruptive physicians

  Badly behaved doctors contribute to medical mistakes, preventable complications, and even death...

Issue 34, November 25, 2008

• Joint Commission FAQ clarifies need for primary source verification

  In a new “frequently asked questions” (FAQ) about its 2009 healthcare accreditation...

• Q&A: Can I, as an MSP, be personally and successfully sued for negligent credentialing?

  Most likely not. Unless a case can be made against you that clearly shows you recklessly...

• From the CRC Blog: Networking can provide relief to economy woes

  The current state of the US economy is affecting many healthcare facilities and, often, having a...

Issue 33, November 18, 2008

• Q&A: How do I verify military service longer than 10 years ago?

  Military service can often be especially challenging to verify, especially if the service occurred...

• Prepare for your next survey with mock inspections, file reviews

  Massachusetts General Hospital is getting ready for its next Joint Commission survey after the...

• State suspends physician's license for arrests and drug use

  The Maryland Board of Physicians suspended the medical license of a physician after an...

Issue 32, November 11, 2008

• From the CRC Blog: Identity theft

  I was curious about the FTC’s and other federal agencies regulations requiring compliance...

• Insurers worry about credentialing in medical tourism

  Even when an American can get an operation in India for a fourth or fifth of the cost of having the...

• Ask the expert: Is there a software system with core privileging forms built in?

  Yes, it’s called Core Privileging Plus. If your facility seeks new or improved credentialing...

Issue 31, November 4, 2008

• Happy National Medical Staff Services Awareness Week!

  As you may already know, this week, November 2-8, is National Medical Staff Services Awareness...

• Los Angeles hospital to fire 19 over criminal records

  The Martin Luther King Jr.-Harbor Hospital in Los Angeles will fire at least 19 employees and...

• Pre-order the 2009 Credentials Verification Desk Reference

  The 2009 Credentials Verification Desk Reference (CVDR) is now available for pre-orders and will be...

Issue 30, October 28, 2008

• Register now for next week’s free verification Webcast

  HCPro is pleased to announce an encore presentation of our free Webcast about how you can use the...

• Verification horror stories

  Earlier this month, we asked Credentialing & Verification Update readers to submit your...

• Medical school applications are down, but enrollment is up

  The Wall Street Journal reports that getting into medical school was just a tad less competitive...

Issue 29, October 21, 2008

• Montana court rules licensure alone is not enough to verify credentials

  The Montana Supreme Court has ruled that the Montana State Board of Medical Examiners is not...

• From the CRC Blog: Categories of medical staff membership

  A question was posed to me the other day about whether or not there should be a place on initial...

• Save the date: Encore presentation of free verification Webcast

  HCPro is pleased to announce an encore presentation of our free Webcast on using the Credentialing...

Issue 28, October 14, 2008

• Q&A: What does The Joint Commission say about verifying applicant health status?

  For Joint Commission-accredited organizations, standards require the organization to not only...

• One week left to submit your verification horror story

  This is your last reminder to submit a verification horror story to Credentialing &...

• ECFMG issues advisory on fraudulent letters of recommendation

  The Educational Commission for Foreign Medical Graduates (ECFMG) has issued an advisory to...

Issue 27, October 7, 2008

• Visit HCPro next week in Milwaukee at the annual NAMSS conference

  Will you be attending the annual conference of the National Association Medical Staff Services...

• Q&A: Do CMS and Joint Commission standards ever vary?

  Yes. One example of a topic where Joint Commission and Centers for Medicare and Medicaide Services...

• Legislation expands Americans with Disabilities Act (ADA)

  President Bush signed legislation last week expanding protections under the Americans with...

Issue 25, September 30, 2008

• NCQA to prohibit pencil in certification documentation

  The National Committee for Quality Assurance (NCQA) has announced that effective January 1, 2009...

• Offer practitioners a friendly reminder to update NPI records

  Physicians and non-physician practitioners are responsible for keeping their National Provider...

• A guide to online medical information from around the globe

  The October 2008 issue of Harvard Health Letter provides an interesting overview of the vast...

Issue 24, September 23, 2008

• Reminder: Submit your verification horror stories

  Credentialing & Verification Update wants to know: Have you experienced a verification...

• Two hospital employees fired for posting patient photos online

  Two employees at the University of New Mexico Hospital (UNMH) were fired for using cameras on their...

• A useful resource for verifying postgraduate PA training programs

  The Association of Postgraduate Physician Assistant Programs (APPAP) provides a list of...

Issue 23, September 16, 2008

• Register for a live demonstration of Core Privilege Plus at NAMSS

  Planning to attend the NAMSS conference on October 13-15 and need to purchase a new or improved...

• Quick tip: Verifying practitioner liability insurance

  Every hospital sets unique policies specifying the level of malpractice insurance coverage...

• Submit your verification horror stories for a chance to win!

  Have you experienced a verification nightmare? This Halloween, HCPro wants to hear your...

Issue 22, September 8, 2008

• From the CRC Blog: What is in your hospital’s future?

  A recent MedScape article by Emily Friedman entitled Hospitals We Can't Afford to Lose stated that...

• Court affirms hospital arbitrarily denied physician's privileges

  A California appeals court affirmed a trial court's ruling that a hospital unfairly terminated a...

• New sample form available on CPDR Online

  A new credentialing form is available for download at the Credentialing and Privileging Desk...

Issue 21, September 3, 2008

• Enter the CRC Blog name contest

  Informational, insightful, and inspirational; the Credentialing Resource Center (CRC) Blog is all...

• Download verification tips from last week’s free Webcast

  If you missed last week's free Webcast, Overcoming verification frustration: Tips and tricks for...

• From the CRC Blog: Nosy staff get the boot!

  Michigan's Governor Janet Granholm was informed on August 6 that there was a breach of the...

Issue 20, August 27, 2008

• Q&A: What should I do if I find that a practitioner's credentials file contains expired documentation?

  Typically, the responsibilities of the medical staff office (MSO) include tracking certain aspects...

• U.S. News & World Report publishes CMS hospital mortality data

  Earlier this week, U.S. News & World Report published a report comparing CMS data on heart...

• From the CRC Blog: Job satisfaction starts with you

  In a few short weeks I will be making a major change in my working world. I'm leaving a position...

Issue 19, August 20, 2008

• Free verification WebEx, including a live CPDR demo, is next week

  HCPro, Inc. will present a free one-hour WebEx presentation on solving verification problems using...

• From the CRC Blog: Swango: A story we should never forget

  Many MSPs are familiar with the book Blind Eye by James Stewart about physician-turned-serial...

• Corrections

  In last week's issue of CVU, we incorrectly stated that the Educational Commission for Foreign...

Issue 18, August 12, 2008

• Quick tip: Verifying foreign medical education

  The Educational Commission for Foreign Medical Graduates (ECFMG) is the only "designated...

• Register now for free verification WebEx, including a live CPDR demo

  HCPro will present a free, one-hour, interactive, WebEx presentation on solving verification...

• Q & A: How long must the medical staff office retain credentialing files?

  The Joint Commission requires hospitals to determine how long to retain medical records based upon...

Issue 17, August 5, 2008

• Q&A: What information must be verified at reappointment?

  At the time of reappointment, the MSP does not need to go back and reverify static information...

• Poliner decision reversed

  A federal appeals court in Texas has reversed a jury decision awarding over $30 million to Lawrence...

• Ensure your facility is listed correctly in the CPDR

  If you did not receive (or did not complete) the recent survey asking for updated primary source...

Issue 16, July 30, 2008

• NIAHO aims to be an accredidation alternative

  There could be a new accreditation organization in town: National Integrated Accreditation for...

• Q & A: Can the medical staff office provide applicants with pre-populated applications for initial appointment or reappointment?

  Many organizations have started to pre-populate applications (both initial and for reappointment...

• America's best hospitals

  U.S. News & World Report released its 2008 hospital rankings in its July 21-28, 2008 issue. The...

Issue 15, July 22, 2008

• Free verification WebEx on Aug. 27th

  HCPro will present a free one-hour live, interactive, WebEx presentation on solving verification...

• Your next practitioner application could be a FAKE!

  We’ve heard about the “secret shoppers” who go into retail stores to evaluate...

• News flash: States creating databases of medical disaster volunteers

  Fifteen of twenty states recently surveyed by the U.S. Government Accountability Office (GAO) have...

Issue 14, July 15, 2008

• From the CRC Blog: Verification and "contingent" approvals

  This time of year, medical staff offices may be busy credentialing residents who are in their last...

• Q & A: When must you query the NPDB?

  Q: When does The Joint Commission require healthcare organizations query the National Practitioner...

• 2009 Joint Commission standards available online

  Last week, The Joint Commission released the pre-publication version of its 2009 hospital...

Issue 13, July 2, 2008

• Ask the expert: Are electronic signatures acceptable on practitioner documents?

  Most organizations are evaluating data collection and their paperwork burden to try to make these...

• Obtaining credentials verification from nursing homes

  A physician comes to practice in your facility after practicing for 15 years in a nursing home...

• Editor's note: Credentialing & Verification Update to be published weekly

  As the new editor of the Online Credentialing and Privileging Desk Reference (CDPR), I am pleased...

Issue 12, June 5, 2008

• Implementation of Joint Commission revised standard MS.1.20 suspended

  The Joint Commission (formerly JCAHO) Board of Commissioners followed the recommendation of a task...

• From the CRC blog: Is there a universal credentialing application in the USA?

  Editor’s note: The following entry appeared June 2 on The Credentialing Resource...

• Q&A: What does the Joint Commission say about getting data on physicians from healthcare facilities that have closed?

  Q&A: What does the Joint Commission say about getting data on physicians from healthcare...

• Quick tip: Protect confidential credentials information

  Medical staff professionals receive many requests for credentials information. While some...

Issue 11, June 4, 2008

• Kadlec ruling overturned: Hospitals have no obligation to disclose information, but information disclosed must not mislead

  A previous court ruling which held that a hospital had a duty to disclose to another facility...

• Q&A: What are the "designated equivalent sources" accepted by The Joint Commission for primary source verification?

  Whenever feasible, verification should be obtained from the original, primary source of the...

• Facts about credentialing and verification: Did you know...?

  Failure to monitor competence constitutes most negligent credentialing cases.

Issue 10, May 21, 2008

• Q&A: What’s the difference between Joint Commission and NCQA standards regarding the use of CVOs?

  Hospitals use credentialing verification organizations (CVO) for many reasons (distributing and...

• Ensure confidentiality during the application process

  Confidentiality plays a key role in credentialing. Information obtained during the credentialing...

Issue 9, May 7, 2008

• Avoiding reappointment hassles: Sending reminder notices and charging late fees

  MSPs often struggle to recieve information for practitioners’ initial appointment or...

• Reader advice: Determining how far back to verify employment history

  In the April 9 issue of CVU, we ran a segment that shared reader feedback on the sometimes...

• Editor’s pick: What’s new on The Credentialing Resource Center?

  The CRC online, relied upon by thousands of MSPs, now has a new section devoted specifically to...

Issue 8, April 9, 2008

• Reader tips: Determining how far back to verify employment history

  In the March 12 issue of CVU, we ran a segment discussing the often-controversial issue of how far...

• Standardize verification methods for credentialing audits

  Does your organization conduct audits to assess the accuracy and efficiency of the current...

Issue 7, March 26, 2008

• HCPro, Inc. launches new logo and tagline as part of its new corporate branding initiative

  HCPro, Inc. is launching a new corporate branding campaign designed to reflect the company's focus...

• Tips for tracking expirations: practitioner licenses

  All licenses should be verified at initial credentialing and reappointment, as well as upon...

• Ask the expert: How long must a credentials file be kept and what should it contain?

  You must address a number of questions before destroying any credentials files or contents thereof...

Issue 6, March 12, 2008

• Tip of the week: Avoid negligent credentialing suits by following up on red flags

  Case law has established that hospitals, and more specifically their medical staff credentialing...

• Q&A: What is The Joint Commission's requirement regarding hearings/appeals for ambulatory

  A: With regard to the hearing and appeals processes, The Joint Commission states that an ambulatory...

• Tips for determining how far back to verify employment history

  The topic of how far back into a practitioner's past to delve with regard to employment and/or...

Issue 5, February 27, 2008

• Q&A: What organization accredits medical schools worldwide?

  A: If you haven't already verified international training or work experience on an application...

• Avoid pitfalls common to the initial appointment and reappointment phases

  A review of case law nationwide reveals a number of common credentialing pitfalls that, if avoided...

• ACP: Protect credentials of physicians prescribing medical marijuana

  The American College of Physicians (ACP) in February released a position paper on the medical use...

Issue 4, February 13, 2008

• Study identifies physicians who stay in-state after training

  Physicians who complete medical school and residencies in the same state are most likely to stay...

• The Joint Commission vs. AOA-HFAP standards surrounding expedited or fast-track credentialing

  As the credentialing process has become more detailed and cumbersome over the past few decades, the...

• Primary source verification of education for licensed independent practitioners

  Q.  When credentialing licensed independent practitioners, can verification of a current...

Issue 2, January 16, 2008

• Take caution when using applications with pre-populated fields

  Many organizations pre-populate medical staff applications (both initial and reappointment) for the...

• Q&A: Should applicants and/or current medical staff members be able to read their letters of reference?

  A: If a hospital promises a reference that his or her letter will not be shared, then of course...

• Reader tip for protecting practitioners' identities during verification

  An item that originally ran in the November 21st issue of CVU, titled "Guidelines for querying...

• Credentialing interrogatories grow and change with evolving credentialing standard

  Applications for medical staff membership have expanded over the years, and one of the most...

• Q: Who can serve as a peer reference for a physician assistant (PA), and how many references are needed?

  Q: Who can serve as a peer reference for a physician assistant (PA), and how many references are...

• The Joint Commission announces MS.1.20 task force

  In its continued effort to address concerns hospitals have about MS.1.20, The Joint Commission...

Issue 13, June 26, 2008

• Survey results shine light on opportunity

  Not only are most Americans not prepared financially for their future healthcare needs, but nine...