The corrective action, summary suspension, and fair hearing processes are high-stakes proceedings and extremely stressful for all involved. Hospitals can alleviate some of this stress by ensuring their medical staff bylaws do not create extra pressure points when managing practitioner behavior...
Credentialing Resource Center Journal - Volume 28, Issue 3
The United States District Court of Maine (the “Court”) ruled in favor of a plaintiff seeking to compel a juvenile reformatory and the Maine Department of Corrections to produce certain documents, finding that self-critical analysis and peer review privileges were not applicable to the case....
Credentialing Resource Center Journal - Volume 28, Issue 3
Following the bylaws is critical because they reflect state and federal laws and regulations, such as the Health Care Quality Improvement Act (HCQIA). These laws and regulations include specific parameters for conducting the corrective action and the fair hearing, says Jon Kammerzelt, partner...
Credentialing Resource Center Journal - Volume 28, Issue 3
The fair hearing is a culmination of several detailed processes that medical staff service departments must follow when addressing concerns about a physician’s competency or behavior.
The following example broadly outlines the steps that result in a fair hearing, but keep in mind:...
Credentialing Resource Center Journal - Volume 28, Issue 2
The Fifth District Texas Court of Appeals at Dallas (the “Court”) affirmed a trial court decision ruling that a surgery center did not breach a contract when it terminated a partnership with a physician who refused to perform an illegal act because the contract specifically stated that said...
Credentialing Resource Center Journal - Volume 28, Issue 2
The 2019 CRC Symposium, being held in Las Vegas February 26–28, features a combination of new and returning speakers, physicians, and medical staff professionals. These speakers are experts in credentialing, privileging, provider enrollment, quality, physician leadership, and medical staff...
Credentialing Resource Center Journal - Volume 28, Issue 2
When medical staff services and provider enrollment processes are integrated into the same office, MSPs may have to work with enrollment specialists to report to stakeholders how providers are tracking through the credentialing and enrollment processes.
Many organizations hold regular...
Credentialing Resource Center Journal - Volume 28, Issue 2
With integrated departments, onboarding of employed practitioners includes credentialing and privileging, but now ends after successfully enrolling practitioners with commercial insurers, Medicare, and Medicaid.
Credentialing Resource Center Journal - Volume 28, Issue 1
Credentialing Resource Center Journal recently sat down with David J. Pugach, JD, vice president of public policy for the American Osteopathic Association (AOA) to ask how ongoing initiatives, such as the single graduate medical education accreditation system, are proceeding and what initiatives...
Credentialing Resource Center Journal - Volume 28, Issue 1
Following a complete, compliant, and risk-adverse initial credentialing and privileging process protects patients, the organizations, practitioners, and even the MSP. However, MSPs often field requests or feel pressure from physician leaders or administrators to skirt the full credentialing...
