The Handbook For Credentialing Healthcare Providers

Author : Sheryl Deutsch
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780834209336
Total Pages : 604 pages
Book Rating : 4.30/5 ( download)

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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.

Author : Ellis Mac Knight
Publisher :
ISBN 13 : 9780997284775
Total Pages : pages
Book Rating : 4.73/5 ( download)

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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:

Author : Ellis Knight
Publisher :
ISBN 13 : 9780997284768
Total Pages : 50 pages
Book Rating : 4.65/5 ( download)

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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

Author : VIRUTI SHIVAN
Publisher : Viruti Satyan Shivan
ISBN 13 :
Total Pages : 240 pages
Book Rating : 4./5 ( download)

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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.

Author : Cindy A. Gassiot
Publisher : Jones & Bartlett Learning
ISBN 13 : 9780763736941
Total Pages : 696 pages
Book Rating : 4.45/5 ( download)

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Download or read book The Medical Staff Services Handbook written by Cindy A. Gassiot and published by Jones & Bartlett Learning. This book was released on 2006-03 with total page 696 pages. Available in PDF, EPUB and Kindle. Book excerpt: Whether You Are An Expert In Medical Staff Services Or A Student Just Starting Out, This Book Provides Solutions To The Most Common Dilemmas. This Guide Provides A Comprehensive Look At All Major Functions Performed In A Medical Staff Services Department. It Contains Practical Advice On Organizing Medical Staff, Carrying Out Procedures, And Resolving Problems Related To Credentialing And Privileging.

Author : Viruti Shivan
Publisher :
ISBN 13 : 9789334036565
Total Pages : 0 pages
Book Rating : 4.67/5 ( download)

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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.

Author : Richard A. Sheff
Publisher : Hcpro Incorporated
ISBN 13 : 9781601469595
Total Pages : 104 pages
Book Rating : 4.94/5 ( download)

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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

Author : Anne Roberts
Publisher :
ISBN 13 : 9781601468529
Total Pages : 0 pages
Book Rating : 4.20/5 ( download)

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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.

Author : National Learning Corporation
Publisher : National Learning Corporation
ISBN 13 : 9781731858412
Total Pages : 152 pages
Book Rating : 4.18/5 ( download)

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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.

Author :
Publisher :
ISBN 13 : 9781556457470
Total Pages : pages
Book Rating : 4.72/5 ( download)

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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: