Is a pre-application form really necessary?

Dear medical staff leader:

Healthcare organizations have used pre-application forms for many years as a way to deter applicants who do not meet specific qualifications set by the hospital from applying for membership or clinical privileges.

Many hospitals began using pre-applications because they believed that if they provided a physician applicant with an application form, which the physician then completed and submitted to the organization, the hospital was then required to process the application with no exceptions. Processing all applications meant that on occasion the hospital found itself forced to deny membership and/or privileges to an applicant who did not meet the organization's established minimum criteria. 

However, even under the best of circumstances, pre-application forms add days or weeks to the time that it takes to process an application. In addition, once an applicant completes and submits a pre-application form, he or she must provide the hospital with much of the same information on the application form. Is it any wonder that physicians often find the initial credentialing process duplicative and bureaucratic?

We now know that organizations are not required to process an application from an applicant that does not meet the organization's requirements. For example, assume that an organization requires that practitioners have no recent history of felony convictions (and recent means within the past 10 years). An applicant indicates on the pre-application that he has had no felony convictions within the past 10 years. The hospital then provides the physician with an application form. During the application process, the medical staff office conducts a criminal background check on the applicant and discovers that the applicant has had a felony conviction within the past 10 years. Is the organization now required to continue processing the application? Must the organization deny membership and/or clinical privileges to this applicant (and offer a hearing)? The answer is both questions is "no." The applicant does not meet the organization's eligibility requirements. Therefore, the organization can inform the applicant of this fact and discontinue processing the application. This would still be true if an application had been provided at the outset.

For this reason, many organizations have discontinued the pre-application process and streamlined the application process by providing the applicants with written information about qualifications and requirements needed to gain membership or clinical privileges. The organization also informs the applicant that his or her application will not be processed if it is determined at any time that the applicant doesn't meet qualifications.

Update you facility's credential process and eliminate steps that are no longer necessary or do not add value to the credentialing process.

Until next time,

Vicki L. Searcy, CPMSM
Practice Director, Credentialing & Privileging
The Greeley Company
vsearcy@greeley.com
www.greeley.com