Download or read book The Credentialing Handbook written by Sheryl Deutsch and published by Jones & Bartlett Learning. This book was released on 1999 with total page 604 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Credentialing Handbook provides comprehensive, plain-English guida nce to understand and master the provider credentialing process in any health care setting. With sample forms, checklists, flowcharts, and c orrespondence, this practical guide walks you through every aspect of effective credentialing, appointment, and recredentialing. You'll lear n: key steps in the credentialing process; about express credentialin g models; how to credential allied health practitioners; typical time frames and tracking systems; pros and cons of delegating credentialin g, plus more.
Download or read book Handbook for Credentialing Healthcare Providers written by Ellis Mac Knight and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Handbook for Credentialing Healthcare Providers written by Ellis Knight and published by . This book was released on 2016-04 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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
Download or read book The Credentialing Coordinator s Handbook written by Anne Roberts and published by HC Pro, Inc.. This book was released on 2007 with total page 239 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medical Credentialing Specialist The Comprehensive Guide written by VIRUTI SHIVAN and published by Viruti Satyan Shivan. This book was released on with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the rapidly evolving world of healthcare, the role of a Medical Credentialing Specialist has never been more critical. "Medical Credentialing Specialist - The Comprehensive Guide" is the quintessential resource for professionals aiming to master the intricate processes of medical credentialing and privileging. This book distills complex regulations and procedures into an accessible format, ensuring readers not only comprehend the foundational principles but also excel in applying them within any healthcare setting. With a focus on practical strategies and real-world scenarios, this guide demystifies the credentialing process, making it an indispensable tool for both novices and seasoned professionals. Understanding the high stakes involved in credentialing for patient safety and organizational integrity, this comprehensive guide emphasizes the importance of accuracy, efficiency, and compliance. It navigates through the myriad of standards and legal requirements with precision, offering up-to-date insights into industry best practices. Note, to respect copyright laws and ensure universal accessibility, this book does not include images or illustrations. Instead, it enriches the reader's understanding through detailed explanations, case studies, and hypothetical scenarios that bring the credentialing world to life. By prioritizing clarity and practicality, this guide stands as an essential read for anyone looking to thrive in the healthcare credentialing field.
Download or read book Physician Credentialing written by Veronica L. Rosas and published by . This book was released on 2015-07-20 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Physician Credentialing: A Guide for Physician Office Staff Veronica L. Rosas, CPCS Credentialing providers in a physician practice is a confusing and time-consuming process that can seem daunting to even the most seasoned professional. Between managing the credentialing of new physicians to the mandatory recredentialing that must be undertaken every few years, it is imperative that practice-based credentialing coordinators are on top of their game. Covering the credentialing process for both hospitals and managed care organizations, Physician Credentialing: A Guide for Physician Office Staff is a must-have, practical, and easy-to-read guide for credentialing coordinators and office managers, whether they are brand-new or experienced. The book walks readers through the required forms, provides suggested timelines, details documentation requirements, and offers tips for multitasking and organizational strategies to maximize efficiency. There is even helpful professional guidance, including information on certification, networking, and education. This resource will help you do the following: Utilize your time efficiently by knowing all the steps in the credentialing process Stay on top of credentialing in the physician practice Plan ahead to manage credentialing for new physicians while maintaining credentials for current providers Table of Contents Preface Part 1: Introduction Chapter 1: Introduction to Credentialing Chapter 2: The Credentialing Application Chapter 3: The Managed Care Credentialing Process Chapter 4: The Hospital Credentialing Process Part 2: Introduction Chapter 5: Credentialing the New Provider Chapter 6: Recredentialing and Reappointment Chapter 7: Managed Care Organization Contracts Chapter 8: Multitasking Chapter 9: Not All Healthcare Organizations Are the Same Chapter 10: On Your Own but Not Alone: Networking, Education, and Certification Conclusion Appendixes Appendix A: Contracting Checklist Appendix B: Acronym List Who should read this book? Credentialing coordinator Credentialing professionals Physician practice manager Physician office manager Physician practice administrator Practice manager Office manager Practice administrator Business manager
Download or read book Medical Credentialing Specialist The Comprehensive Guide written by Viruti Shivan and published by . This book was released on 2024-03-22 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Unlocking the Secrets to Success in Healthcare Credentialing In the rapidly evolving world of healthcare, the role of a Medical Credentialing Specialist has never been more critical. "Medical Credentialing Specialist - The Comprehensive Guide" is the quintessential resource for professionals aiming to master the intricate processes of medical credentialing and privileging. This book distills complex regulations and procedures into an accessible format, ensuring readers not only comprehend the foundational principles but also excel in applying them within any healthcare setting. With a focus on practical strategies and real-world scenarios, this guide demystifies the credentialing process, making it an indispensable tool for both novices and seasoned professionals. Understanding the high stakes involved in credentialing for patient safety and organizational integrity, this comprehensive guide emphasizes the importance of accuracy, efficiency, and compliance. It navigates through the myriad of standards and legal requirements with precision, offering up-to-date insights into industry best practices. Note, to respect copyright laws and ensure universal accessibility, this book does not include images or illustrations. Instead, it enriches the reader's understanding through detailed explanations, case studies, and hypothetical scenarios that bring the credentialing world to life. By prioritizing clarity and practicality, this guide stands as an essential read for anyone looking to thrive in the healthcare credentialing field.
Download or read book Credentials Committee Essentials Handbook written by Richard A. Sheff and published by Hcpro Incorporated. This book was released on 2014-05-14 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: Get the knowledge needed to serve as an effective Credentials Committee Member and fulfill the role well. The Credentials Committee Essentials Handbook clarifies the critical role of the credential committee member and their responsibilities in relation to MEC, quality committee, and department chairs. With this handbook credentialing committee members can over come the challenges of insufficient leadership training and equip them with the information they need to serve as an effective committee member throughout their appointment. Plus, to make staff training easy, this handbook includes a customizable PowerPointr presentation highlighting key takeaways covered in the handbook. Benefits of Credentials Committee Essentials Handbook: * Earn CE and certification credits * Assess, document, and comply with The Joint Commission's core competencies * Verify the competence of advance practice professionals and allied health professionals * Understand the role of physician leaders in focused professional practice evaluation (FPPE), ongoing professional practice evaluation (OPPE), and peer review * Overcome challenges presented by low- and no-volume providers and legal issues such as negligent credentialing * Avoid costly, time-consuming fair hearings * Oversee professional conduct and confront disruptive behavior What's inside: * State the four steps of credentialing by the MEC, governing board, department chairs, committees, and medical staff leaders * Identify the role of the credentials committee member in relation to the MEC, quality committee, and department chairs * Explain what focused professional practice evaluation is and is not * Summarize the medical staff response to a physician requesting new technology privileges * Identify two targets to create three performance levels * Describe the strategic and competency goals of low- and no-volume providers, impaired physicians, and aging physicians * Name the primary drivers of privilegin
Download or read book Physician Credentialing written by and published by . This book was released on 2015 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Certified Provider Credentialing Specialist written by National Learning Corporation and published by National Learning Corporation. This book was released on 2019-02 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Certified Provider Credentialing Specialist Passbook(R) prepares you by sharpening the skills and abilities necessary to succeed on your upcoming entrance exam.
Download or read book The Medical Staff Professional s Handbook written by Anne Roberts and published by . This book was released on 2011-06-23 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Medical Staff Professional''s Handbook The essential medical staff professional''s job manual Let your experienced peers provide you with the guidance and training you need to tackle your toughest challenges.The Medical Staff Professional''s Handbook is a comprehensive job manual developed by medical staff professionals (MSPs) Anne Roberts, CPMSM, CPCS, and Maggie Palmer, MSA, CPMSM, CPCS. While providing much-needed education for new MSPs, this book and downloadable toolkit also offer veterans new ideas, tips, sample policies, customizable forms, and advice for improving medical staff and credentialing processes. After reading this book, you will be able to: Define the roles, tasks, and expectations for MSPs to clearly identify their priorities Manage FPPE and OPPE processes to effectively assess physician competency Streamline and improve credentialing and privileging processes with dozens of customizable forms and sample tools Comply with accreditation and regulatory standards by understanding the MSP''s role in accreditation and the consequences of noncompliance Discover important tips to save time and increase efficiency on daily medical staff office tasks Support the medical staff and communicate with leadership Table of ContentsAbout the Authors Introduction Acronyms and Abbreviations Section I: The Successful Medical Staff Professional Chapter 1: Roles and Responsibilities of Medical Staff Professionals The Responsibilities of MSPs Who MSPs Support in the Organization Chapter 2: Managing External and Internal Relationships Navigating External Relationships Navigating Internal Relationships Chapter 3: Review of Credentialing, Privileging, and Medical Staff Standards History of Regulatory Agencies How the Standards Apply to MSPs Joint Commission Requirements What MSPs Should Expect During Accreditation Surveys Chapter 4: Legal and Regulatory Considerations for Medical Staff Professionals Managing Bylaws Rules and Regulations Corrective Action and Due Process Policies and Procedures HCQIA of 1986 NPDB Healthcare Integrity and Protection Data Bank Sharing Information Credentialing Interrogatories Attestation, Acknowledgments, and Release Forms Criminal Background Checks Disruptive and Impaired Practitioners Section II : Effective Credentialing and Privileging Chapter 5: The Credentialing Process Credentialing Basics Rules to Guide Your Credentialing Process Roles and Responsibilities During the Credentialing Process The Application Process Collecting and Verifying Information Review and Approval Process Chapter 6: Credentialing Responsibilities After the Initial Application Orientation for Patient Care Organizations Credentials Expiration Tracking and Ongoing Monitoring Tips for Avoiding Claims of Negligent Credentialing Chapter 7: The Privileging Process Implementing a Privileging Process Developing Clinical Privilege Delineations Granting Clinical Privileges Based on Competency Final Recommendations for Privileges Chapter 8: Reappointment Initiating the Reappointment Process Accepting the Application Performing Primary Source Verification Creating the Reappointment Profile Quality Review, Ongoing Evaluation, and Monitoring Review and Approval Chapter 9: Credentialing and Privileging Hurdles Low- and No-Volume Practitioners Allied Health Practitioners Telemedicine Practitioner Data and Document Confidentiality Leaves of Absence Paperless/Paper-Light Credentialing System Transition New Technology Privileging Chapter 10: Temporary, Emergency, and Disaster Privileges and Expedited Board Approval Temporary Privileges Emergency Privileges Disaster Privileges Fast-Track or Expedited Credentialing Section III : Measuring Practitioner Competency Chapter 11: Focused Professional Practice Evaluations Requirements for an FPPE Policy and Process Developing FPPE Criteria FPPE at Initial Granting of Privileges Tracking Completion of FPPE FPPE for Additional Privileges FPPE for Cause (Ongoing Professional Practice Evaluation, Peer Review, Leave of Absence Reinstatement) Chapter 12: Ongoing Professional Practice Evaluations Developing a Systematic Approach to OPPE Developing Quality Indicators Periodic Performance Feedback Reports Section IV : Sample Forms and Policies Credentialing Sample Forms Privileging Sample Forms Reappointment Sample Forms Competency Sample Form Continuing Education This book has been approved by the National Association Medical Staff Services for 5 continuing education units. Accreditation of this educational program in no way implies endorsement or sponsorship by NAMSS.
Download or read book US Army Physician Assistant Handbook written by and published by . This book was released on 2018-02 with total page 460 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Handbook of Patient Safety Compliance written by Fay A. Rozovsky and published by John Wiley & Sons. This book was released on 2016-12-05 with total page 283 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written for virtually every professional and leader in the health care field, as well as students who are preparing for careers in health services delivery, this book presents a framework for developing a patient safety program, shows how best to examine events that do occur, and reveals how to ensure that appropriate corrective and preventative actions are reviewed for effectiveness. The book covers a comprehensive selection of topics including The link between patient safety and legal and regulatory compliance The role of accreditation and standard-setting organizations in patient safety Failure modes and effect analysis Voluntary and regulatory oversight of medical error Evidence-based outcomes and standards of care Creation and preservation of reports, data, and device evidence in medical error situations Claims management when dealing with patient safety events Full disclosure Patient safety in human research Managing confidentiality in the face of litigation Managing patient safety compliance through accountability-based credentialing for health care professionals Planning for the future
Download or read book Handbook of Medical Tourism Program Development written by Maria K. Todd and published by CRC Press. This book was released on 2011-12-08 with total page 255 pages. Available in PDF, EPUB and Kindle. Book excerpt: Explaining how to develop a patient-centered medical tourism program, the Handbook of Medical Tourism Development is the ideal guide for any hospital, clinic, hotel, spa, or ancillary facility wishing to become a medical tourism provider. From high-cost surgery, transplants, diagnostics, and preventive wellness checkups, to medical and wellness spa
Download or read book The Medical Staff Handbook written by and published by Joint Commission Resources. This book was released on 2011-07 with total page 236 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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
Download or read book Health Care Credentialing written by Fay Adrienne Rozovsky and published by Aspen Publishers. This book was released on 2007-06-22 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: b>Health Care Credentialing, takes you far beyond the standard review of credentialing concerns, delivering insights into innovative ways to collect, process and assess credentialing information. No matter where you're conducting credentialing, this resource will help you keep pace with the latest ideas and approaches. Specifically, Health Care Credentialing will help you: Take into account complex laws, regulations, and accreditation standards as they apply to credentialing Handle disruptive care and clinical competency issues Access information for evaluating core competencies to be used in credentialing Stay up-to-date on relevant regulations, statutes, and accreditation standards Health Care Credentialing helps you address the critical issues in this important arena. This unique resource delivers: Coverage of credentialing for disaster management Innovative processes to upgrade clinical competencies outside the credentialing system Guidance on Board and IRB credentialing Innovative perspectives to address behavioral problems and disruptive individuals Cutting-edge approaches to "Pay-For-Performance" and credentialing Ahead-of-the-curve insights into credentialing and federal requirements such as the ADA Rehab Act Section 504 and EEOC guidance In addition, Health Care Credentialing will help you: Keep pace with credentialing standards and relevant state and federal requirements Launch important credentialing initiatives Implement alternative programs to address emerging credentialing issues And much more! Health Care Credentialing has been updated to include: New sections on: New ACOs: Physician-Hospital Alignment Changes in Medical Staff Structures Technology Utilization Competency Innovative Bylaws and Credentialing Advanced Diagnostic Imaging Credentialing Discussion of changes in the proposed rule for the Healthcare Integrity and Protection Data Bank (HIPDB) and the National Practitioner Data Bank (NPDB) Updated information on credentialing for advanced practice practitioners Updated information on telemedicine Discussion of the May 2012 revisions to the medical staff and nursing services Conditions of Participation Updated information on the final rule for screening and program requirements for ACOs Discussion of the following cases: Smigaj v. Yakima Valley Memorial Hospital West Florida Regional Medical Center v. See Gargiulo v. Baystate Health, Inc. Effective reversal of the Archuleta decision by Utah Code section 78B-3-425 Cawthorn v. Catholic Health Initiatives Iowa Corp. d/b/a/ Mercy Hospital Medical Center Appeal of Sternberg v. Nanticoke Memorial Hospital Jablonsky v. Sierra Kings Healthcare District Preau v. St. Paul Fire and Marine Insurance Company Lawnwood Medical Center Inc. v. Randall Seeger Smith v. Cleveland Clinic Gaalla v. Brown State of Rhode Island Department of Health Board of Medical Licensure and Discipline, In the matter of Alexandra Thran, MD Updated discussions of and references to The Joint Commission's 2012 Hospital Accreditation Standards
Download or read book Medical Credentialing Specialist The Comprehensive Guide written by Viruti Satyan Shivan and published by Viruti Satyan Shivan. This book was released on 2024-02-28 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Unlocking the Secrets to Success in Healthcare Credentialing In the rapidly evolving world of healthcare, the role of a Medical Credentialing Specialist has never been more critical. "Medical Credentialing Specialist - The Comprehensive Guide" is the quintessential resource for professionals aiming to master the intricate processes of medical credentialing and privileging. This book distills complex regulations and procedures into an accessible format, ensuring readers not only comprehend the foundational principles but also excel in applying them within any healthcare setting. With a focus on practical strategies and real-world scenarios, this guide demystifies the credentialing process, making it an indispensable tool for both novices and seasoned professionals. Understanding the high stakes involved in credentialing for patient safety and organizational integrity, this comprehensive guide emphasizes the importance of accuracy, efficiency, and compliance. It navigates through the myriad of standards and legal requirements with precision, offering up-to-date insights into industry best practices. Note, to respect copyright laws and ensure universal accessibility, this book does not include images or illustrations. Instead, it enriches the reader's understanding through detailed explanations, case studies, and hypothetical scenarios that bring the credentialing world to life. By prioritizing clarity and practicality, this guide stands as an essential read for anyone looking to thrive in the healthcare credentialing field.