Following a fair and thorough investigation, the medical staff in your hospital has determined a physician has clinical performance issues and has recommended a limitation in clinical privileges. Per the medical staff bylaws, a fair hearing process commences. If the hearing/appeal processes do...
Credentialing Resource Center Journal - Volume 28, Issue 10
Although the peer review coordinator is involved throughout the case review process, the coordinator has the primary responsibility at the beginning of case review and through the following four steps: case identification, case screening, review preparation, and physician reviewer assignment. It...
Credentialing Resource Center Journal - Volume 28, Issue 10
Delegated credentialing has the potential to improve enrollment turnaround times for providers, decrease paperwork for practitioners and staff, and reduce lost or delayed revenue. However, the process for attaining delegation status with commercial payers encompasses a number of critical steps...
Credentialing Resource Center Journal - Volume 28, Issue 10
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.
