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PubMed1992

National credentialing. Implications of the development of provincial regulatory bodies.

The CSLT Board feels that it has developed a structure that will allow it to deal with provincial regulatory bodies as they develop while continuing to cooperate with provincial societies. It has accepted that there will be significant changes in the role of the CSLT, particularly in the area of credentialing. The primary concern of the CSLT is national standards and portability of certification. The Board is committed to responding to the changes brought about through provincial regulatory legislation and to working with the bodies designated under this legislation to preserve national certification.

Canada↗
PubMed1992

Economic credentialing and the fraud and abuse caveat.

Courts often uphold hospital credentialing decisions based in part on economic criteria. Nonetheless, as this article discusses, arrangements where medical staff privileges or other benefits appear to be offered to physicians as an incentive to refer patients may be suspect under the Medicare/Medicaid fraud and abuse law.

Antitrust Laws↗
PubMed1994

How to tie a drug therapy improvement program to physician credentialing.

The pharmacy staff and the management information system specialist at St. James Hospital and Health Centers, a 472-bed community medical center located in Chicago Heights, Illinois, developed a computer program for documenting the drug use patterns of physicians. This program was not only helpful in improving the appropriate use of medications within the institution, it was also tied to the prescriber credentialing process. How the program evolved as well as the cost savings/cost avoidance achieved as a result of the drug therapy improvement process is presented.

Cost Savings↗
PubMed1994

Credentialing in managed care.

Through the use of managed care techniques in recent years, the insurance industry has tried to bring the runaway costs of medical care under control. The result of this control effort is system access limitations, compared to the full choice indemnity plans of the past. This limited system access has now clearly moved HMOs and other managed care organizations into the category of "potentially liable health care entities," based on patient steerage, economic disincentives, and limited choices of the plan's participating providers and facilities. Just as hospitals have had to exercise rigorous care in the credentialing of members of their medical staffs, managed care organizations will have to ensure that the providers they use meet acceptable standards of competence.

Credentialing↗
PubMed1993

Economic credentialing survey of university teaching hospitals.

Economic credentialing, the process of applying economic criteria to the determination of initial appointments or reappointments of physicians to hospital medical staffs, has become a major issue in hospital medical staff relations. Nearly all major academic health center hospitals have the ability to perform economic analyses of faculty/physician clinical practices, and more than one-third of their CEOs see nothing wrong with terminating or denying hospital privileges for excessive use of hospital resources. Sixty-eight percent of surveyed academic health center respondents currently develop and review physician practice profiles, but only 35 percent of these respondents include economic data.

Academic Medical Centers↗
PubMed1991

Duties and potential liability of nonhospital entities in credentialing physicians.

This article discusses the duties of hospital governing boards, medical staffs, medical staff officers, and individual medical staff members regarding the credentialing of physicians, including the potential liability of these groups for negligent medical care and wrongful denial of staff privileges. This article also proposes possible measures these groups may take to avoid or limit their exposure to such liability.

Credentialing↗
PubMed1997

Automation comes to the aid of credentialing efforts.

Virtually every hospital and managed care plan performs credentialing for every physician, and it can be a labor-intensive--and redundant--effort. But administrative software tools are being developed and expanded to better gather and keep track of vital information about physicians. Some providers and health plans are also working together to centralize the process by electronically sharing the information.

Chicago↗
PubMed1995

Development of a computerized physician credentialing database.

This case study defines the concerns, options and solutions to developing an automated central repository and database. The database would include physicians' credentialing information that, in turn, will make the managed care organizations' application process more manageable and effective, thereby retaining and/or increasing patient volume and revenue.

Credentialing↗
PubMedDate not supplied

Physician credentialing. A centralized verification system.

The current system for credentialing physicians in the U.S. is staggeringly redundant, prone to error, and expensive. The process for establishing a recent graduate's practice can involve an average of five applications to have privileges at several hospitals and HMOs. A centralized verification system needs to be developed to streamline this process. The amount of information that would have to be stored for all physicians in the country would be immense. However, the technology currently exists to store such information on a much grander scale. Credit unions, banks, and insurance companies utilize such computer systems effectively and with reasonable confidentiality.

Costs and Cost Analysis↗
PubMed1985

Standards for the accreditation of educational programs for and the credentialing of radiologic personnel--PHS. Final rulemaking.

These regulations establish standards for the accreditation of educational programs for radiologic personnel, and for the credentialing of such persons. These standards are part of the implementation of the Consumer-Patient Radiation Health and Safety Act of 1981 (Title IX of Pub. L. 97-35), which required their promulgation by regulation. The standards are voluntary for States and mandatory for Federal agencies.

Credentialing↗
PubMed1986

Impact of the medical record credential on data quality.

This research study was funded by the Foundation of Record Education of the American Medical Record Association. The Department of Medical Record Administration at the University of Illinois, Chicago, was awarded the grant in the summer of 1984. The purpose of the study was to evaluate the quality of coded and abstracted medical record data and to determine if a relationship existed between data quality and the professional credentials of the individuals who manage and/or supervise the collection of these data. The study consisted of three phases: a telephone interview conducted of 83 hospitals, recoding and reabstracting of medical records performed by the staffs of 59 hospitals, and 34 random on-site visits for a reliability check. Data was collected and analyzed from each of the three phases of the study.

Abstracting and Indexing↗
PubMed1987

Effective quality controls: the credentialing process and medical staff leadership.

Two presentations given at the AMRA Annual Meeting in Denver received high praise from participants for the way in which they addressed physician-related quality assurance issues. Some of the material developed by Sue King, CMSC, who spoke on "Physician Credentialing Systems," and by William Jessee, MD, who gave a presentation entitled "Developing Medical Staff Leadership for Effective Quality Assurance," is offered to the wider JAMRA audience in the following article.

Credentialing↗
PubMed2001

Navigating the maze: how to choose and get the CM credential you need.

CERTIFICATION: Do you need one? How do you find one that best suits your career goals? Case management certification provides a real leadership opportunity and increases customer confidence, say experts in the field. Certification also gives you a competitive edge in a growing industry. So how do you go about choosing a credential that matches your expertise and positions you for career advancement? Several industry leaders give their advice for health professionals choosing a certification to pursue.

Career Mobility↗
PubMed2001

Understanding the terms: a credentialing glossary.

Case managers sling certification jargon around, often without knowing the differences between credentialing, certificates, certification, accreditation, and licensure. As presented at a recent conference for hospital case managers sponsored by the Case Management Society of America, here is a list of terms you should know, as well as the definitions and meanings behind them.

Case Management↗
PubMed2000

Credentialing becomes a priority for JCAHO.

Your medical staff credentialing and peer review policies could come under careful scrutiny in the coming months as the Joint Commission on Accreditation of Healthcare Organizations takes aim at the effectiveness and professionalism of evaluation processes. At its most recent Executive Briefings Conference, the Joint Commission developed a list of characteristics for peer review that eventually could be incorporated into Joint Commission standards.

Credentialing↗
PubMed2001

HHS database is risky source for credentialing.

Hospitals are running a considerable risk if they rely too heavily on the National Practitioner Data Bank (NPDB) as a source of information throughout their credentialing process. A report released recently by the General Accounting Office, which found the data bank riddled with problems, only underlines that point. The government watchdog agency says problems of underreporting to the NPDB make it a questionable source of information regarding disciplinary actions taken against health care practitioners by hospitals and other health care providers.

Credentialing↗
PubMed2001

Defining the learning curve for the Focused Abdominal Sonogram for Trauma (FAST) examination: implications for credentialing.

Focused Abdominal Sonogram for Trauma (FAST) examination is being used increasingly for the torso evaluation of injured patients. In a controlled setting using peritoneal dialysis patients as models for injured patients with free fluid we hypothesized that more experienced providers would perform FAST with greater accuracy. Twelve fellow or attending level trauma surgeons, two radiologists, and one ultrasound technician were studied for their ability to detect intraperitoneal fluid (0-1600 cm3) in nine peritoneal dialysis patients with two different volumes of dialysate/patient. FAST experience with injured patients was defined as minimal (<30 patients examinations), moderate (30-100), or extensive (>100). All surgeons had participated in a didactic/practical course before the study. Test results were reported as "+" or "-" by the participant; "+" results were further quantified by volume. The sensitivity of those in the minimal-, moderate-, and extensive-experience to detect <1 L was 45, 87, and 100 per cent, respectively; the accuracy in detecting dialysate volume within 250 cm3 was 38, 63, and 90 per cent, respectively. In this controlled setting the accuracy of FAST particularly in diagnosing smaller volumes, as well as the ability to quantify volume, improves with experience. The learning curve for FAST starts to flatten out at 30 to 100 examinations. Training and credentialing policies should consider these findings to optimize patient care.

Abdominal Injuries↗