Healthcare Practitioner Credentialing Toolkit

The process of credentialing and privileging staff is one of the most important duties a healthcare organization undertakes. Through thorough vetting of a practitioner’s competence and qualifications, practitioners can increase the likelihood that their provided care will be of high quality and delivered in a safe manner. Without a sound system of credentialing in place, facility leaders place patient safety in jeopardy, increasing the potential for medical accidents and hospital liability.

Use the credentialing resources provided in this toolkit to ensure that your hospital or medical facility is properly vetting and assessing the level of skill and professionalism in your staff.

Credentialing Compliance

Maintaing compliance in credentialing is a very important function for healthcare organizations and providers. The process needs to be hardwired to ensure that all regulatory requirements are met. These resources provide compliance techniques in the credentialing process for healthcare organizations.

  • Webinar


    Credentialing Compliance: Documenting Practitioner Credentials and Competency Webinar

    One of the biggest challenges of any medical staff is evaluating and documenting the competency of providers. In order to support this need, having an effective and efficient credentialing and privileging system is vital.

    This webinar dives into the importance of credentialing. Topics include:

    • Appropriate mechanisms for documenting credentials
    • Forms and processes for documentation of competency
    • The concept of negligence in credentialing

    TAGS: credentials, Competency, licensure, malpractice, Hospital, government

  • Checklists


    6 Common Areas of Liability Exposure During Credentialing

    During the credentialing process, a medical facility may open itself to unwanted positions of liability if certain factors are overlooked. This downloadable resource discusses six common areas of liability exposure during the credentialing process to help prepare your team.

    In addition to areas of exposure, the document also provides insights that explain how a plaintiff attorney uses this information and what administrators can do to protect their facility.

    TAGS: Processes, exposure, six, Resources, plaintiff, attorney

  • Guidelines/Recommendations


    Dealing with Disruptive Physicians

    Disruptive physician behavior negatively impacts patient safety, staff satisfaction and increases the likelihood of medical malpractice claims. Disruptive behavior poses a challenge for leaders in healthcare to address and it is important for leaders to have a plan in place to handle them when they arise. This article from MGMA addresses how to confront physicians with behavioral issues and how to develop an organizational plan of handling disruptive behavior that will promote a change in culture.

    TAGS: Medical, malpractice, Claims, MGMA, organizational, Behavioral

Credentialing Processes

This resource provides a step-by-step focus on healthcare credentialing processes.

  • Webinar Slides

    Webinar Slides

    Credentialing Committee Orientation Presentation

    Provided below is a downloadable PowerPoint presentation on the responsibilities and related processes of the credentialing committee. This is a useful tool in the orientation and onboarding of new committee members, offering an overview of the expectations placed on the committee with regards to patient safety.

    The information within the presentation should be used as a guide and edited as necessary to reflect your facility’s specific process.

    TAGS: orientation, onboarding, committee, Members, expectations, Patient, Safety

  • Webinar Slides

    Webinar Slides

    Implementing an Effective Faculty Performance Evaluation Process (FPPE/OPPE) PowerPoint

    This presentation provides information about OPPE/FPPE as it relates to a healthcare organization and the Joint Commission. It will:

    • Review how different healthcare organizations manage OPPE/FPPE
    • Discuss skills to implement policies, procedures and implementation tools

    TAGS: OPPE, FPPE, Healthcare, Managers, skills, Policies, Procedures, implementing

  • National Association Medical Staff Services

    The National Association Medical Staff Services focuses on enhancing the professional development of and recognition for professionals in the medical staff and credentialing services field. The website provides NAMSS members educational, certification and regulatory resources.

    TAGS: NAMSS, Members, Educational, certification, regulatory

Credentialing Tools

It is important to have standardized tools and processes in place for credentialing. These resources provide tools your organization can utilize for the healthcare provider credentialing process.

  • Checklists


    Sample Credentials File Chart Audit Form

    Healthcare providers and facility administrators can use this sample credentials file chart audit to ensure compliance with hospital standards and policy. The downloadable form provides a comprehensive checklist field including necessary elements of review to ensure credentialing documentation is in place for physicians on staff.

    Through thorough assessment using this form, you can determine which physician files at your own facility are out of compliance with proper credentialing procedures, helping to safeguard against accidental oversights and room for liability.

    TAGS: facility, administrators, Hospital, Policy, Physicians, Staff, Assessment, Procedures

  • Checklists


    Comprehensive Credentialing Checklist for Hospitals

    The credentialing process is information-intensive, often requiring a multitude of components for completion. Staying organized and updated on what details you need is important in the successful implementation of the credentialing process.

    To stay on target with your assessment process, use our Comprehensive Credentialing Checklist to ensure that all needed information has been verified prior to presenting for next level of approval or review.

    TAGS: components, reviewed, Checklist, credentialing

  • Policy Templates

    Policy Templates

    Sample Focused Professional Practice Evaluation Plan Form

    While licenses offer a benchmark for the training of an employee, these hardly gauge how competent the physician may be at a particular skill. When onboarding new medical staff members, it’s essential to evaluate their individual competencies and professionalism to ensure it’s streamlined with your facility’s quality of care.

    Use the sample Focused Professional Practice Evaluation (FPPE) form provided to quickly assess your new staff members.

    TAGS: Medical, Staff, FPPE, license