Leading up to the 21st century, peer review evolved constantly, undergoing rapid change. New regulations and requirements were implemented both by the Centers for Medicare & Medicaid Services (CMS) in the 1960s and by the establishment of the Health Care Quality Improvement Act of 1986....
Credentialing Resource Center Journal - Volume 29, Issue 3
The 2010s are officially over. However, it’s worth a peek back into the last decade at the top trends and changes over the last 10 years for MSPs. We saw changes to what’s expected of MSPs among their healthcare colleagues, the rise of employed physicians, and new technologies that presented...
A recent survey shows provider directory maintenance can be expensive and that, in the absence of an affordable technical fix, you’ll have to tighten up your record updating if you want to reduce those costs.
CAQH, the nonprofit alliance of health plans and trade associations best known...
Credentialing Resource Center Journal - Volume 29, Issue 2
A privilege dispute among practitioners can be overwhelming, to say the least. In these situations, it is up to medical staff leaders and medical staff professionals (MSP) to remain calm, review processes and policies, and not jump to any quick solutions just to settle the dispute.
Ensuring that patients receive quality care is the utmost priority for both physicians and MSPs. The federal government seeks to maintain this priority through the Stark Law and Anti-Kickback Statute, both of which prohibit physicians from referring patients to entities where...
Credentialing Resource Center Journal - Volume 29, Issue 2
Physicians request leaves of absence for both personal and business reasons, such as overseas military assignments, extended education, parental leave, and health issues. Generally, medical staff bylaws allow a medical staff member to obtain, for good cause, a voluntary leave of absence. Keep...
Whether you’re an MSP in the medical staff services department or a practitioner on the medical staff, understanding how to work effectively on a team is crucial, particularly if you are the leader. Leadership styles can vary greatly, and some teams and/or...
Credentialing Resource Center Journal - Volume 29, Issue 1
A New Jersey Court of Appeals (the “Court”) affirmed a trial court’s decision, finding that unnecessary patient transfers may constitute an “imminent risk,” which can serve as grounds for the suspension and/or revocation of a physician’s privileges.
The plaintiffs, Robert Patel, MD, and...
Credentialing Resource Center Journal - Volume 29, Issue 1
As APPs increasingly specialize in areas of practice, medical staff services departments (MSSD) must evolve their privileging practices to ensure that APPs are only granted privileges for the procedures they are competent to perform.
Credentialing Resource Center Journal - Volume 29, Issue 1
Succeeding as a medical staff services manager/director requires more than just knowing the ins and outs of credentialing, privileging, and medical staff bylaws. You must also know how to be a leader, deal with stressful situations, manage your staff, manage your time, and delegate work tasks....
