This handbook enables your organization to systemize the tedious, ongoing, and mandatory process of credentialing your medical staff and to understand why you must! Healthcare organizations must have credentialed medical staffs to deliver their services. The reasons are two-fold: First, educated, licensed, experienced, and proven caregivers ensure that a hospital or medical practice is capable of delivering quality care. Secondly, payers require that the physicians and other licensed healthcare professionals are qualified and licensed to work with their patients. Before receiving payment for services, the provider must have specific credentials for providing that service. Verifying and documenting the credentials of a healthcare provider is tedious, ongoing, and mandatory. An organization with a large medical staff may struggle with keeping the credentialing function current, as many licenses have rolling expirations. Credentialing ensures that clinical practitioners are duly qualified, licensed, and board certified. It reports the history of malpractice claims, state-instituted sanctions, or other undesirable professional circumstances of providers. Credentialing and privileging of healthcare professionals protects patients and hospitals by minimizing the risk of medical errors that may result from the work of incompetent providers. It also undergirds the reputation and credibility of the institution in the eyes of providers and across the healthcare community. Further, credentialing with insurers forms the basis for reimbursement for professional services. Without the acceptance of the professional credentials of a provider, insurers and other third-party payers will not compensate his or her claims. The purpose of this book is to explain the necessity and to provide the process for the official documentation of each practitioner. The information presented in these chapters will serve as a practical resource for strengthening your organization's credentialing function. = Book Features! -Outlines the necessity for credentialing in the delivery of care and in attaining reimbursements for services provided -Explores options for in-house and outsourced credentialing function -Provides systematic process for ongoing credentialing operations

Identifies key responsibilities of the hospital, the organized medical staff, and the medical staff executive committee and governing board in granting and reviewing clinical care credentials and privileges. This title also provides examples for improving compliance.

The Medical Staff Handbook is the completely updated edition that provides an in-depth explanation of Joint Commission standards that address all medical staff issues, including the recently revised MS.01.01.01 standard. This reliable one-stop resource provides information on the credentialing, privileging, and appointment processes for hospital practitioners. The Medical Staff Handbook also includes the following: * An appendix with all Joint Commission Medical Staff standards, rationale, elements of performance, and scoring information * Complete coverage of medical staff bylaws and other areas affected by the revised MS.01.01.01 standard * Thorough interpretation of all Joint Commission standards related to the medical staff * Tips for developing new medical staff processes and improving existing processes for appointment and reappointment * Sample documents, practical strategies, and detailed examples to help readers understand and comply with the Medical Staff standards

This book addresses the wide range of issues that face the program leader – from how to choose a site and how to negotiate for equipment, to how to determine staffing requirements and how to anticipate and defuse possible turf issues with other programs and services in the hospital or healthcare facility. The early chapters of this book focus on the leadership of your program whether in your department or institution. The second section centers on education at all levels recognizing that smaller machines have made ultrasound available for medical students to advanced practitioners. The third section provides detailed logistics on equipment, maintenance, and safety. The fourth section focuses on a quality improvement program and includes a chapter on the workflow process. For those with limited budgets we also offer a section on practical operating and educational solutions. The fifth section offers insight into hospital level credentialing, quality assurance, national politics, and recent issues with accreditation. This is followed by reimbursement and coding. The last section covers topics in specialized communities. Chapters focus on ultrasound in global health, emergency medical services, pediatrics, critical care, community and office based practices. Multiple US working documents including checklists, graphs, spreadsheets, tables, and policy appendices are included.

Best practices for compiling and using data in reappointment decisions, navigating credentialing considerations for nonphysician practitioners, preventing turf battles, and avoiding legal issues

The Medical Staff Leader''s Survival Guide William K. Cors, MD, MMM, FACPE An affordable, time-sensitive solution to medical staff leadership training. Physicians who accept or are assigned leadership positions are often left on their own to develop leadership skills and educate themselves about their responsibilities as medical staff leaders. Just because a physician is a great clinician does not mean he or she is a great leader. The challenges of being a successful medical staff leader are twofold: You must be well-versed in your role and responsibilities (i.e., peer review, credentialing, medical staff bylaws), and you must inspire other medical staff members to follow the rules while continuing to deliver excellent patient care. A well-trained medical staff leader is vital to the culture of a hospital''s medical staff and can save a hospital from the expense of lawsuits affiliated with negligent credentialing/peer review. This book aims to teach physicians how to become great medical staff leaders and how to motivate other medical staff members on topics such as: AHP credentialing and supervision Reappointment challenges Physician-hospital competition Liability risks Medical staff disharmony and distrust Table of Contents Chapter 1: Where to Begin? Principles of Governance Chapter 2: Meetings: The Cost of Holding a Meeting Chapter 3: Meetings: How to Run an Effective Meeting Chapter 4: Overcoming Physician Apathy Chapter 5: Job Descriptions: Medical Staff Leaders Chapter 6: The VPMA/CMO: Where This Fits Chapter 7: Credentialing and Privileging: Requirements, Guidelines and Tips Chapter 8: New Technology Privileges Chapter 9: Privileging Disputes and How to Resolve Them Chapter 10: Advanced Practice Professionals Chapter 11: Low-Volume, No-Volume Practitioners Chapter 12: The Aging Physician Chapter 13: Proctoring (FPPE) Chapter 14: Peer Review (OPPE): Some Best Practices Chapter 15: Dealing with the Physician with Problems Chapter 16: Corrective Action: The Good, the Bad and the Ugly Chapter 17: Physicians and Hospital Administration: They''re Just Different Chapter 18: EMTALA and Emergency Department Coverage Chapter 19: Conflicts of Interest Chapter 20: Economic Credentialing Chapter 21: Physician-Nursing Relationships Chapter 22: Health Care Finance: A Primer Chapter 23: Medical Errors Disclosure Chapter 24: Employed Practitioners Chapter 25: Contracted Practitioners Chapter 26: Confidentiality Chapter 27: Accreditation and Regulation Chapter 28: Bylaws and Related Documents Chapter 29: Medical Staff Governance: Myths and Misconceptions Chapter 30: Personal Characteristics of Great Leaders Who will benefit from this book? Directors of medical staff offices, vice presidents of medical affairs, medical staff presidents, credentials committee chairs and members, committee and department chairs