For legal and financial reasons, economic credentialing is a concern of the governing board, not of the medical staff. Antitrust laws preclude physicians from deciding whether to admit or deny membership to their physician competitors based on economic factors. The financial “big picture” is...
CMS requires that medical staffs must have a policy for fair hearing and appeal. An applicant or an individual holding a medical staff appointment is entitled to request a hearing when the MEC or the board has made an unfavorable recommendation regarding staff membership or privileges.
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Credentialing Resource Center Journal - Volume 26, Issue 1
The New Year’s dust (or confetti, as the case may be) has settled, routine is restored, and 2017 stretches ahead. For MSPs, medical staff leaders, and quality personnel, there’s no better time to take stock of last year’s professional developments, applying lessons learned to current approaches...
Credentialing Resource Center Journal - Volume 25, Issue 12
Although CMS has now substantially limited the ability of a hospital to establish provider-based (PB) locations, they have been extremely popular over the past few years because they allow a hospital to bill for services as if they were provided at the main hospital building (i.e., each service...
Most credentialing work is considered a peer review activity performed by the medical staff and governing board. As a result, state laws generally grant some amount of peer review protection to those parts of a particular credentials file that are acted upon by medical staff committees or the...
