WHO SHOULD PARTICIPATE: CMOs, credentialing professionals, medical services professionals, medical staff leaders, department chiefs, credentials committee members, medical executive committee members, medical directors, and legal and quality staff
OVERVIEW:
This webinar series will focus on the following:
- Providing an in-depth overview of basic aspects of credentialing, including primary source verification, applying criteria for appointment, reviewing the application for completeness, and roles in the review and approval process;
- Having a comprehensive, criteria-based privileging system, which is an essential element of the medical staff’s role. The increased focus on quality by accrediting organizations, the government, and the public emphasizes the need for continual monitoring of the quality of services provided and having a strong privileging system.
- Identifying of “red flags” or information that indicates that there may be a problem that should be addressed.Some red flags are easy to identify, and others are more subtle. This webinar will discuss how to identify potential red flags, follow-up of these issues, and appropriately document this follow-up.
- Discuss the concept of negligence as it relates to credentialing and privileging. The presenter will discuss past and recent negligent credentialing lawsuits and their impact on the credentialing practices of the hospital.
LEARNING OBJECTIVES:
Part One & Part Two: Credentialing Basics
- Track the credentialing process from application through governing body approval;
- Define what constitutes a “complete” application;
- Recognize the roles of various persons involved in the review and approval process;
- Discuss primary source verification and which sources are appropriate; and
- Determine sources other than primary that can be utilized.
Part Three: Privileging
- Recognize the importance of acquiring evidence to document competency;
- Discuss the Centers for Medicare & Medicaid Services (CMS) and Joint Commission requirements for privileging and documenting competency for privileges; and
- Discuss CMS regulations and Joint Commission requirements for credentialing telemedicine practitioners in both acute care and critical access hospitals.
Part Four: Identifying Red Flags in the Credentialing and Privileging Processes
- Discuss today’s “red flags” and how they differ from those of the past;
- Discuss appropriate follow-up of information received in the application process; and
- Determine how to document medical staff evaluation of red flags.
Part Five: Understanding Negligence in Credentialing
- Define negligence as it relates to credentialing and privileging;
- Recognize an organization’s duty to exercise due care in credentialing; and
- Discuss processes that may help to reduce the chance of a finding of negligence in credentialing
MEET YOUR FACULTY: Kathy Matzka, CPMSM, CPCS, FMSP; Speaker Bio
CONTINUING EDUCATION: NAMSS: This program has been approved for 7.5 NAMSS continuing education credits by the National Association Medical Staff Services (NAMSS). Nursing: 7.5 contact hours will be awarded for this offering by the Louisiana Hospital Association for complete attendance of the program. The Louisiana Hospital Association is approved by the Louisiana State Board of Nursing – CE Provider #39. Participants will receive, upon completion of workshop, a certificate documenting the completed continuing education/clock hours.