Problem
Discuss a basic reference for new physicians that outline the credentialing process and medical staff appointment/reappointment process. It should be an at-a-glance, quick reference in the form of a narrative.
Summarize the credentialing function including:
1) Purpose of credentialing
2) Relationship to healthcare quality
3) Criteria examined in the credentials verification process
4) Differentiation of NCQA and JC credentialing requirements
5) Explain the role of the HIM Department, medical staff and governing board in the credentialing process
6) Outline the medical staff appointment/reappointment process to include the differentiation of the roles of medical staff leadership, committees, and the governing board in the process
7) Describe specific data collected/reviewed for decision making.
8) Identify and describe verification sources (NPDB, Healthcare Integrity and Profile Data Bank, AMA physician Master file) and process of verification.