How MSPs can help prevent negligent credentialing

MSPs play a critical role in preventing negligent credentialing, and they are the first stop on the tour when a negligent credentialing claim raises its ugly head. To help prevent such claims, MSPs can do the following:

• Carefully review each entry in a practitioner’s application, and compare it to their CV and other paperwork.
• Verify all education, training, and experience (i.e., affiliations and work history from medical school forward).
• Verify all state licenses and Drug Enforcement Administration registrations (a practitioner can have multiple registrations for each state in which he or she practices; ensure that all registrations are verified).
• Query the malpractice insurance companies for at least the past 10 years. Companies are required to report payments to the NPDB; however, there are reasons why an MSP may not see a claim reported when he or she queries the National Practitioner Data Bank (NPDB). For example, if a claim is recent, the insurance company may have not yet reported it when the MSP queried the NPDB. Also, legal intervention on behalf of the practitioner could delay reporting. Query the NPDB as required. If a report is present, request a statement from the practitioner, in his or her own words, describing the event, and add that to the file.
• Obtain appropriate peer references. Appropriate means a peer that is not related, not in direct monetary competition or partnership with the practitioner, of equal education and training, and familiar with the practitioner’s current practice. If the medical staff office receives questionable responses, discuss them with the medical staff leadership (e.g., department chair, credentials committee chair, or MEC chair) to see whether they wish to contact the reference for additional information.
• Run an internet search. Enter the practitioner’s name, his or her state(s) of practice, and the word complaints or malpractice after it. Be specific. If a social profile presents itself, review it.

Most importantly, it is important that MSPs do not let pressure from other medical staff members cause them to take shortcuts in their process. MSPs are responsible for thoroughly completing this process and discovering anything that might cause issues for the patients and the organization.