03 Dec Simulate the process of obtaining and verifying information. Use online resources to validate data, documenting findings on the checklist. Note: When veri
My Part:
Section B (Verification and Review): Simulate the process of obtaining and verifying information. Use online resources to validate data, documenting findings on the checklist.
Note: When verifying the educational qualifications of a job applicant, it is essential to ensure that the information provided in their resume is accurate. For instance, if the resume claims that the applicant attended Florida State College or the University of Texas School of Medicine, you can cross-check this information by visiting the official website of the institution in question. Suppose the website clearly states that the institution does not have a School of Medicine. In that case, you should proceed to element B of the verification process and deny the applicant's hiring.
Do not call institutions for verification purposes. In real life, the institution would provide certified documents to confirm the applicant's education.
- Review each resume's checklist sections, documenting actions taken in the "Note" column with a maximum of two (2) sentences. If unable to perform a specific activity, describe the appropriate process.
- Include initiation and finalization dates for each action, demonstrating the timeline of the credentialing process.
- Provide a summary statement, limited to five (5) sentences, indicating whether each candidate was hired and the reasons behind the decision.
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Hospital of Hope
Credentialing Checklist Board Members: (enter the team name and names of team members)
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STANDARD TO BE MEASURED |
ACTION TAKEN? |
DATE |
COMMENTS |
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A: APPLICATION |
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Name of Applicant: Alice Wilson |
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Position Requested: |
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1. Applicant Identifying Information: |
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a. name and address |
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b. education and training |
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c. prior employment |
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d. board certifications |
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e. current state license and Drug Enforcement Administration (DEA) certification, if applicable |
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f. current competencies (i.e., skills and experience) |
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g. written statement seeking clinical privileges |
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h. personal and professional references (minimum of three) |
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2. Applicant Issues: |
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a. loss of medical professional liability coverage |
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b. loss of DEA number |
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c. suspension/revocation of privileges |
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d. past claims history |
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e. criminal charges |
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f. prior professional disciplinary actions |
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3. Release for background investigations: |
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a. Applicant executes a written consent and release from liability, to be attached to every reference inquiry. |
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b. Applicant is provided a copy of applicable rules and regulations. |
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c. Applicant agrees in writing to exhaust administrative internal remedies before litigating adverse credentialing decisions. |
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B: VERIFICATION AND REVIEW |
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1. Verify completion of education. |
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2. Ask the director or other authorized responsible party of the applicant’s residency or training program to complete a questionnaire regarding the applicant’s performance and capabilities. |
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3. Check dates of employment history and document any gaps in employment or appointment. |
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4. Obtain a copy of applicant’s DEA certificate and state medical license, if applicable. |
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5. Query the National Practitioner Data Bank and adhere to the requirements of the federal Health Care Quality Improvement Act of 1986. https://www.npdb.hrsa.gov/index.jsp * |
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6. Verify the status of existing clinical privileges at other facilities. |
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7. Check with state and federal regulatory bodies for previous sanctions by Medicare and Medicaid programs. |
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8. Obtain a copy of applicant’s current medical professional liability insurance certificate, including verification of limits of coverage and claims experience. |
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9. Verify by telephone all information contained in written references. |
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C: DELINEATION OF CLINICAL PRIVILEGES |
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1. Applicant provides the clinical appointment committee with a written request for clinical privileges. |
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2. Committee processes the written request for clinical privileges based on established protocols and criteria. |
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3. Committee votes to approve or deny request. |
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4. Administrative leadership receives committee’s recommendation and makes final decision. |
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D: REAPPOINTMENT OF CLINICAL PRIVILEGES |
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1. Reappointment process occurs annually or, at minimum, every two years. |
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2. Committee verifies and documents the following information upon request for reappointment: |
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a. any changes in certification, appointment, education or professional accomplishments |
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b. verification of current license and DEA certification, if applicable |
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c. any professional disciplinary action taken against applicant |
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d. medical professional liability insurance coverage and claim experience |
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e. status with National Practitioner Data Bank, if applicable |
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E: PERFORMANCE APPRAISAL IS COMPLETED AND INCLUDES THE FOLLOWING INDICATORS: |
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1. Service usage |
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a. admissions data |
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b. drug utilization |
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c. utilization of lab and radiology services |
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2. Ratio of completed patient care records to delinquent patient care records |
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3. Results of member/patient satisfaction survey results |
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4. Results of quality improvement findings/outcomes for the provider |
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5. Result(s) of clinical peer-review findings |
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6. Clinical appointment committee reviews reappointment form and performance appraisal? (If yes when and indicate whether annual or special review) |
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7. Results of clinical appointment committee review: (Select either a or b below and include comment as to why |
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a) Reappointment is granted either without change to prior privileges, or with modified privileges? (State which) |
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b) Reappointment is denied, and applicant is notified via a letter, which also provides information about hearing procedures. (Explain why denied) |
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For the purpose of this team assignment, this form created and modified from Health Provider Services Organization Checklist.
The complete form can be found at:
Staff Credentialing Checklist Health Providers Service Organization (HPSO)
http://www.hpso.com/risk-education/individuals/articles/Staff-Credentialing-Checklist
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Hospital of Hope
Credentialing Checklist Board Members: (enter the team name and names of team members)
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STANDARD TO BE MEASURED |
ACTION TAKEN? |
DATE |
COMMENTS |
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A: APPLICATION |
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Name of Applicant: John Hayden |
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Position Requested: |
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1. Applicant Identifying Information: |
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a. name and address |
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b. education and training |
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