Confirm medical staff members' malpractice insurance

Every hospital sets unique policies specifying the level of malpractice insurance coverage practitioners must carry. When coverage is required by the organization’s medical staff bylaws, institutional policies, or rules and regulations, the medical staff services department must verify that each applicant’s coverage is current and meets the organization’s minimum standards. The medical staff must also investigate any professional liability actions resulting in a decision against the applicant or any out-of-court malpractice settlement payments.

During the primary source verification process, credentialing specialists should correspond directly with applicants’ current and previous insurance carriers to confirm dates of coverage and the type of coverage the physician held, and to obtain claims histories (e.g., claims, lawsuits, settlements) for the past 10 years. In addition, your credentialing process should require practitioners to provide an explanatory statement and additional documentation if they have a settlement, adverse judgment, or any pending professional liability actions on their records.