Navigating the reappointment process, with its patchwork of expiration dates and verification expectations, can be difficult for ambulatory facilities, which often lack the dedicated credentialing presence of their acute care counterparts.
Provisional credentialing is an optional process that a health plan may incorporate into its credentialing policy. This process provides a managed care organization with the ability to add practitioners to its network prior to completing the full credentialing process. The intention of...
Credentialing Resource Center Journal - Volume 26, Issue 1
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...
