Credentials File Summary of Adverse or Potentially Adverse Issues

MSPs should know how to identify and address red flags during the initial credentialing and recredentialing processes to avoid potential risks in important areas, such as the following:

1. Patient safety and care quality: Poor outcomes are likelier when practitioners exercise clinical privileges for which they are not competent or qualified.
2. Legal standing: Lawsuits may come from patients who experience poor care outcomes at the hands of a practitioner who was granted privileges without further investigation into flags.
3. Compliance: Noncompliance with state, federal, or accreditation standards can jeopardize the organization’s accreditation, deemed status, and/or operating license.

Reduce such risks by paying attention to application details, identifying areas of concern and red flags, and following your credentialing policies and procedures. Use this form for documenting red flags or other issues that require further follow-up with the practitioner, as defined in your credentialing policies and procedures. Enclose the completed form in the applicant’s file for key stakeholders’ consideration throughout the vetting process.