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 Verify and Comply written by Carol S. Cairns and published by HC Pro, Inc.. This book was released on 2004 with total page 174 pages. Available in PDF, EPUB and Kindle. Book excerpt:

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 2022 Hospital Compliance Assessment Workbook written by Joint Commission Resources and published by . This book was released on 2021-12-30 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Health Professions Education written by Institute of Medicine and published by National Academies Press. This book was released on 2003-07-01 with total page 191 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

Download or read book Credentialing Privileging and Medical Staff Governance written by Sheri Patterson and published by . This book was released on 2018 with total page 269 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Credentialing a to Z written by Mary Long and published by . This book was released on 2015-09-28 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Credentialing A to Z is an on-the-go reference packed with easy- to-digest information, Q&As, quizzes, notes, and downloadable forms that will help MSPs gain knowledge about their tasks and the value of their work, enhance team-building, and combat burnout and stress. Author Mary Long, CPMSM, brings in-depth insights, a light touch, and a sense of humor that fellow MSPs will appreciate. This valuable reference guide addresses, defines, and explains your toughest topics in alphabetical order, including: A: Applications-where all credentialing processes start, and possibly end. APPs-are advanced practice professionals processed through the medical staff services department or human resources? B: Bylaws, policies, and rules and regulations-do you know where your medical staff information is? C: Credentialing-the right information to verify, and the correct way to do it. G: Governance-an organized medical staff requires governance in order to function. But what does that have to do with credentialing? M: Meetings-medical staff management in "minutes." P: Peer evaluations, FPPE, and OPPE-who's a peer? Who's a good peer? Privileging-the whens and hows of core privileges, disaster privileges, emergency privileges, and temporary privileges of all stripes. R: Reappointment-building and sticking to a cycle. Red flags-spotting them, stopping them, and getting answers. V: Verification-the querying process, the organizations, and the information they provide. X, Y, and Z: Xenon, yag lasers, and zero data (mastering medical terminology-no, CABG isn't "cabbage") Credentialing A to Z provides new MSPs and credentialing coordinators on-the-job spot training that will build and test their knowledge in a fun way before they're put to the test with less-fun credentialing challenges (such as surveys). All quizzes, Q&As, and other forms are downloadable and customizable, allowing MSPs to tailor them to their programs.

Download or read book The Medical Staff Leader s Survival Guide written by William K. Cors and published by Hcpro, a Division of Simplify Compliance. This book was released on 2014-06-27 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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

Download or read book The Credentials Committee Manual written by Mark A. Smith and published by . This book was released on 2016-05-30 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Best practices for compiling and using data in reappointment decisions, navigating credentialing considerations for nonphysician practitioners, preventing turf battles, and avoiding legal issues

Download or read book The Medical Staff Office Manual written by Marna Sorensen and published by . This book was released on 2015-08-28 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Medical Staff Office Manual: Tools and Techniques for Success Marna Sorensen, CMPSM The Medical Staff Office Manual: Tools and Techniques for Success is a comprehensive guide that maps every aspect of the medical staff office, from onboarding and orienting physicians to querying other facilities for practitioner information and effectively collaborating with physician leadership. In this in-depth manual, author Marna Sorensen, CMPSM, provides MSPs guidance on their role within an organization, quick access to accreditation and regulatory information, and job descriptions and customizable forms to simplify a constantly growing list of daily responsibilities. This book will help you: Consolidate everything you need to do your job into one place Detail procedures for all of your daily tasks, including practitioner data queries, acceptance letters, job descriptions, performance reporting, and sample forms Demonstrate what you do on a daily basis and clearly define your many roles as an MSP--no more questioning who is responsible for what! Update medical staff office functions and get the word out using the new technologies at your disposal Table of Contents Introduction/How to Use This Manual Medical Staff Organization and Staffing Medical Staff Office Job Descriptions The Credentialing Process Medical Staff Clinical Privileges Advanced Practice Professionals Templates for Most-Used Forms Medical Staff Policies HR or MSO?

Download or read book Managed Care Credentialing written by Amy N. Niehaus and published by . This book was released on 2019 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: The role of the MSP is expanding to include payer enrollment and delegated credentialing responsibilities for managed care organizations. Traditionally siloed, MSPs are now beginning to take on both responsibilities, which means they must learn the nuances of managed care credentialing as well as the regulatory and accreditation requirements of NCQA, CMS, and URAC. Managed Care Credentialing: Compliance Strategies for Health Plans, CVOs, and Delegated Entities provides the answers to MSPs' inevitable questions as they begin to manage the tasks of payer enrollment and delegated credentialing. Author Amy M. Niehaus guides readers through each payer's requirements, the differences between hospital and managed care credentialing, and how to help their organization establish delegated credentialing agreements and prepare for audits. As new and existing MSP responsibilities begin to collide, this resource also outlines ways MSPs can modify their current processes to reduce duplication of efforts and develop a comprehensive and compliant managed care credentialing program. Whether you are new to managed care credentialing or are taking on delegated credentialing responsibilities, this book will help you: Learn the regulatory and accreditation requirements related to managed care credentialing Streamline the provider enrollment process through delegation Meet your organizational goals of compliance, operational efficiency, cost savings, and practitioner satisfaction Identify the differences between hospital and managed care credentialing

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 Redesign the Medical Staff Model written by Jonathan Burroughs and published by ACHE Management. This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Winner of the 2016 ACHE James A. Hamilton Book of the Year Award Healthcare organizations are facing many challenges in this new era of healthcare reform, one of which is to establish a new operating model for the organized medical staff. Deeply rooted in tradition, the current medical staff model can no longer hold in an environment where quality, safety, service, and cost-effectiveness are required for healthcare organizations to not only survive but truly thrive. In this book, the author, an experienced physician leader and healthcare consultant, describes key changes that must be made to redesign the medical staff model. He provides specific guidance and examples to help healthcare leaders and executives work with their physician leaders to face these changes successfully. Well-regarded contributors and subject matter experts offer additional examples and insights with special content throughout the book. The author provides an in-depth look into: The evolution of the physician culture from autonomy to collaboration and accountability that must take place for US healthcare providers to remain competitive in an increasingly global economy Select strategic medical staff development planning and credentialing/privileging approaches that are needed to ensure physician-organization alignment Components of an effective and rigorous performance management system that enables leaders to help physicians achieve mutually agreed-on goals and metrics and align them with those of the organization Medical staff performance assessment and improvement activities, including peer review best practices, ways to incentivize excellence, and how to address issues in a timely, compassionate way Negotiation of performance expectations with management and the hospital's board that are consistent with the organization's strategic plan Physician engagement and alignment strategies that will enable physicians and management to work together to achieve the goals of population health and reduced operating costs Healthcare executives and administrators, physician executives, and board leaders can use this book as a guide to learn from organizations that have successfully integrated and aligned with their medical staffs into a collaborative environment. Examples of organizations with medical staffs that have made a complete commitment to the success of their enterprises and the health of their communities are incorporated throughout the book.

Download or read book The Credentialing and Privileging Toolbox written by Merella Schandl and published by . This book was released on 2017-03-01 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: MSPs and medical staff leaders do enough vetting for practitioner applications without worrying about tracking down and validating resources that support structurally sound credentialing and privileging processes. Featuring an array of field-sourced, expert-endorsed forms that facilitate regulatory compliance, policy development, and routine credentialing communications, The Credentialing and Privileging Toolbox lightens the administrative load so MSPs and medical staff leaders have more time for duties that foster high-quality care and patient safety. Inspired by our popular OPPE and FPPE toolboxes, The Credentialing and Privileging Toolbox offers a bevy of sample forms, policies, letters, plans, reports, and related resources that healthcare organizations of various scope, size, and service focus are currently using to execute effective practitioner vetting processes. Included tools, which come from in-the-trenches MSPs and medical staff leaders, have been curated and appraised by expert author Merella Schandl. The resulting collection reflects industry best practices, the wide range of modern healthcare entities that credential and privilege practitioners, and the various aspects of a successful vetting approach. Tools are arranged by type and topic for easy navigation. Within each tool, Schandl highlights key components and provides targeted analysis on tailoring the sample to individual facility needs.

Download or read book Medical Staff Credentialing written by Vivian A and published by . This book was released on 2021-01-18 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt: You should buy this book if: You are a corporate trainer seeking either an outline for training in Medical Staff Credentialing or looking to supplement your current training curriculum.You want to learn the Medical Staff Credentialing process on your own.Even if you have already done credentialing, but need either a refresher, or to learn parts of the credentialing process you may not know.You are considering Medical Staff Credentialing as a career move

Download or read book The Medical Staff Services Handbook written by Cindy Gassiot and published by Jones & Bartlett Learning. This book was released on 2011-08-24 with total page 523 pages. Available in PDF, EPUB and Kindle. Book excerpt: Rev. ed. of: The medical staff services handbook / [edited by] Cindy A. Gassiot, Vicki L. Searcy, Christina W. Giles. c2007.

Download or read book Verify and Comply written by Carol S. Cairns and published by . This book was released on 2009-11 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: Verify and Comply: A Quick Reference Guide to Credentialing Standards, Fifth Edition Carol S. Cairns, CPMSM, CPCS The Joint Commission... NCQA... CMS... DNV... HFAP... Searchable and side-by-side! Verify and Comply, Fifth Edition, is the much anticipated next edition of one of HCPro's most popular credentialing resources. Many satisfied customers have used this resource to study for their NAMSS certification exams and to keep up to date with accreditors' credentialing standards. This newly expanded guide addresses Joint Commission, NCQA, and CMS standards in the book, as well as DNV and HFAP on the companion CD-ROM. That means five sets of accreditors' standards are side-by-side and searchable by topic on CD-ROM. Get the resource thousands of MSPs have come to rely on. It will help you: Easily access, navigate, and compare the requirements of all five organizations at a glance Eliminate wasted time searching through multiple resources to find what you need Stop struggling to interpret the standards on your own Understand the differences between the stages of the credentialing process--appointment, reappointment, and ongoing assessment Get answers to your credentialing questions quickly and easily Study for your CPCS and CPMSM certification exams No other resource for credentialing standards offers you this level of expertise and convenience. All five sets of standards side-by-side, organized by topic, on a searchable CD-ROM The Joint Commission NCQA CMS DNV HFAP Three sets of standards in print in the book (The Joint Commission, NCQA, and CMS) Straightforward, complete summaries of standards Expert interpretation of the standards Distinct sections that clarify the differences between each stage of the credentialing process A tips section that allows for further analysis Special notations to readers who are studying for the CPMSM/CPCS exams Who will benefit? Credentialing specialist/analyst Medical staff services coordinator Director of medical staff services Credentialing coordinator Credentialing manager Medical staff professional Survey coordinator Earn continuing education credits! This program has been approved by the National Association Medical Staff Services for up to 3.0 continuing education unit(s). Accreditation of this educational program in no way implies endorsement or sponsorship by NAMSS. Navigate credentialing standards faster and easier. Order your copy today.