Fundamentals of Credentialing

On-Demand

April 12, 2021
Credentialing: What Is It and Why Do It?

One of the highest risk procedures in any healthcare organization is not a medical procedure itself; it is credentialing. Credentialing protects patients from incompetent practitioners. Medical staff professionals and medical staff leaders are charged with ensuring their organization has a solid credentialing process. Yet, they are often not given the training they need to undertake this important task. In this course, expert Kathy Matzka, CPMSM, CPCS, FMSP, provides an introductory look at what credentialing is, what steps a credentialing process should include, and what everyone’s role is in credentialing. Feel confident that your new medical staff professionals and medical staff leaders will fully understand what credentialing entails after taking this course.

Learning Objectives:

– Describe the key steps in the credentialing process for both initial credentialing and recredentialing

– Identify essential elements to be verified and appropriate verification sources

– Discuss “red flags” and how to identify them

– Determine appropriate mechanisms for following up with verification sources

– Describe expedited credentialing and determine when it is acceptable to use such a process

– Define the roles and responsibilities of each person/committee participating in the credentialing process

The Concept of Privileging

Appropriate delineation of privileges requires fair and consistent analysis of a provider’s education, training, and competence. This in turn requires medical staff professionals and medical staff leaders to have a deep knowledge of privileging. This course provides an introduction into the concept of privileging, different privileging systems, and everyone’s role in the privileging process. Feel confident that your new medical staff professionals and medical staff leaders will fully understand what privileging entails after taking this course.

Learning Objectives:

– Describe the key steps in the privileging process and the roles and responsibilities of each person/committee participating in the process

– Compare various privileging systems

– Discuss the process for development of privileging criteria

– Explain what is meant by emergency privileges, disaster privileges, and temporary privileges

Understanding Peer Review and Performance Monitoring

Peer review ensures that your practitioners continue to meet your organization’s expectations for quality care. This course will explain the basics of peer review: what it is, why it is important, which standards govern peer review, and how to make the organizational changes needed to implement effective peer review and performance monitoring. Feel confident that your new medical staff professionals and medical staff leaders will fully understand what peer review entails after taking this course.

Learning Objectives:

– Compare and contrast performance improvement and quality assurance

– Identify what is considered peer review and discuss peer review protections

– Discuss the process for development of quality indicators

– Describe the roles and responsibilities of each person/committee participating in the peer review process

– Recognize quality monitoring indicators for managed care

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