A California Court of Appeals for Division Seven of the Second Appellate District reversed and remanded with directions a trial court’s decision, finding that the terms of an agreement between a physician and hospital cannot be enforced when they conflict with a state-mandated procedure.
Credentialing Resource Center Journal - Volume 28, Issue 8
Last time, we reviewed tips and tools for initiating a provider onboarding and credentialing consolidation project. A key consideration for leading a project of this magnitude and complexity is transparency among stakeholders and involved teams. Interdependence is always part of a large...
Credentialing Resource Center Journal - Volume 27, Issue 11
The United States District Court for the Southern District of Ohio Western Division (the “Court”) denied a hospital’s motion to dismiss a claim of negligent credentialing of an independent surgeon facing multiple federal charges. The motion to dismiss the negligent credentialing claim is one...
Credentialing Resource Center Journal - Volume 27, Issue 7
In managed care credentialing, delegation is defined as a formal process by which an organization gives another entity the authority and responsibility to perform certain functions on its behalf through a contractual arrangement. Delegation can provide many benefits to both organizations, but...
Credentialing Resource Center Journal - Volume 27, Issue 6
The difference between being accredited as a hospital or as an outpatient center can mean a difference of thousands of dollars in revenue when billing Medicare. And if you are a smaller, specialty hospital or an outlying facility that is part of a larger health system, be prepared: CMS and other...
Credentialing Resource Center Journal - Volume 27, Issue 5
In a 4-3 decision, the Supreme Court of Pennsylvania (the “Court”) recently affirmed a Superior Court decision to uphold a trial court’s ruling that limited the scope of the state’s Peer Review Protection Act (PRPA). The Court ruled that peer review documents are only protected by the PRPA if...