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...
Since microhospitals are currently subject to regulations developed decades ago and with larger acute care institutions in mind, they can run into compliance obstacles that their traditional counterparts don’t often encounter or are better equipped to handle. Compared to a tertiary hospital,...
A sound understanding of the Health Insurance Portability and Accountability Act (HIPAA) and how to apply its requirements in practical, real-world settings is the foundation of a successful compliance program—one that fulfills an organization’s legal obligations while defending patients, staff...
Credentialing Resource Center Journal - Volume 27, Issue 4
Are you aware that there is credentialing going on in your hospital—and it’s not in the medical staff department? If you are, you’re in the minority. Just like many are not aware that a medical staff services department (MSSD) exists, few people give a thought to all those “others” roaming the...
State laws have established certain requirements for the licensing of healthcare practitioners and organizations. Beyond these exist various federal regulatory requirements, only some of which are tied to state or local law.
Because peer review is a medical staff–led initiative, the specific process varies between organizations. At our hospital, when a practitioner’s performance in a particular case raises concerns, the peer review coordinator (who has a clinical background) receives an initial request for peer...