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Tuesday, December 20, 2005

DUBLIN, Ireland -- Research and Markets ( has announced the addition of The Credentialing and Privileges Manual, 2nd edition to their offering

The Credentialing and Privileges Manual is a unique and important resource designed to assist hospitals, health plans and medical groups in the design and implementation of exemplary credentialing and privileging programs for physician and non-physician clinical practitioners. It was developed as a tool for Credentialing Committee members and credentialing staff who must perform this critical function in an organized, timely and objective manner on behalf of the medical staff and governance body.

A 330 page tool box of credentialing policies, procedures, and delineated privilege checklists for all physician specialties plus allied health professionals or nonphysician clinicians. Health systems, HMOs, PPOs, hospitals and medical groups use the Credentialing and Privileges Manual to design and implement exemplary credentialing and privileging programs for physician and non-physician clinical practitioners.

This manual is focused on criteria for the granting of core and delineated privileges for primary and specialty physicians and non-physician clinicians (often called physician extenders, allied health professionals or midlevel practitioners) such as Nurse Practitioners, Nurse Anesthetists, Nurse Midwives, Surgical Assistants, Psychologists and Podiatrists..

Extensive and detailed example lists of privileges for each specialty are included in an easy-to-use checklist format. References, Web sites. Continuously updated as new recommendations become available from specialty societies and other resources.

Preface - Introduction; Procedure credentialing vs core credentialing; JCAHO bylaws and other credentialing requirements; Standard of care for credentialing and privileging processes; Document handling;

Credentials - Why credential?, Credentials Committee, Procedure credentialing vs. core credentialing; JCAHO Medical Staff By-laws requirements; Peer Review; Negligent credentialing; Economic credentialing; Bylaws and Credentials, Provider Credentials and Privileges - Policy and Procedures, Credentialing Processes, Recredentialing, Request for Provider Application - response letter, Request for Application, Application and related documents, Provider Release/Consent Form, Release of Insurance Information Form, Addendum to Provider Legal History Form, Provider Evaluation Form, Application Process; Working Document For Coordinators Use, Letters/Forms To Verify Internship/Residency Training, Provider Application Credentialing Form Check Lists, Provider Letter re: Required Documents Between Credentialing Cycles, Providers, DEA Certification form, ADA implications for medical staff privileges, Release of appointment application to hospital medical staff for use by PHO or another external organization, Monthly 'Hot Sheet' Review - recommendation; High Risk Providers, Provider Sanctions, Criminal background checks, Public Law Title IV (HCQIA), Practitioner Health Status Request Letter, Primary Verification by State Medical and Dental Boards, Web Sites for Online Verification by State and Specialty Boards,

Voluntary resignation/Leave of Absence Policy; Adverse recredentialing or privileges determinations - fair hearing, Licensure Examination Scores - relation to quality of practice.

Peer (physician/physician and physician/staff) Evaluations - Physician - Physician Evaluation Procedures and Forms, Physician/Physician, Self-Evaluation and Physician/Staff Forms.

Privileges: Introduction to Privileging, Requirements for the granting of privileges, Staffing plan, Limited privileges, Temporary Privileges, Emergency/disaster privileges, Proctoring, Board Certification, Competency, Core privileges, Request for privileges to perform a 'new' procedure; Volume considerations as a privileging criteria for procedures;

Setting or Location for the Exercise of Surgical or Invasive Procedure Privileges; Monitoring Procedures Performed that Require Specific Privileges; Cross-Department Privileges by procedure (ECG interpretation, Swan-Ganz catheter insertion, vasectomy, sigmoidoscopy, hyperbaric oxygen therapy, amniocentesis, thoracotomy tube insertion and management, tympanocentesis, C-sections, endoscopies);

'On-call' cross-departmental privileges, Processing Privileges, Privileges Signature Sheet, Signature and Record Sheet for Granting Privileges, Loss of privileges due to inactivity; Privilege requests for new technology, devices or procedures; Volume considerations as a privileging criteria for procedures; Setting or Location for Exercise of Surgical or Invasive Procedure Privileges.

Delineation of Privileges: by specialty (core and detailed privileges lists and criteria are included for each specialty or subspecialty)

Anesthesiology, Anesthesiology Proctor Assessment Form, Cardiovascular/Thoracic Surgery, Dentistry and Oral Surgery, Arthroscopy of the Temperomandibular joint, Dermatology, Emergency Medicine; Family Practice; Delineation of cross-departmental privileges including electrocardiogram interpretation, Swan Ganz catheter insertion, Vasectomy, Flexible sigmoidoscopy, Hyperbaric oxygen (HBO) therapy, Amniocentesis, Thoracotomy tube insertions and management, Cesarean section, Endoscopy procedures - diagnostic, therapeutic to include colonoscopy, snare polypectomy, variceal hemastasis, EGD, ERCP, esophageal dilation/stent placement, laparoscopy; 'On call'; Electrodiagnostic tests; Integrative or Complementary/Alternative Medicine

Internal Medicine I, II, III, IV; Core criteria for Allergy and Immunology subspecialty III/IV privileges; Core criteria for Endocrinology and Metabolism subspecialty III/IV privileges; Core criteria for Infectious Disease subspecialty III/IV privileges; Core criteria for HIV privileges; Core criteria for Nephrology subspecialty III/IV privileges; Core criteria for Rheumatology subspecialty III/IV privileges; Core criteria for Pulmonary Disease subspecialty III/IV privileges; Cardiology/Cardiovascular Surgery Subspecialty III/IV procedure privileges criteria: Carotid endarterectomy; Direct current cardioversion, elective; Exercise treadmill test (Stress Test) privileges; Echocardiography, Stress Echocardiography privileges, references; Permanent pacemaker placement privileges; Impedance Cardiography; Percutaneous transluminal coronary angioplasty (PTCA) privileges; Cardiac catheterization; Intracoronary stent implant privileges; References for angioplasty, stents, cardiac catheterization; Percutaneous balloon valvuloplasty (PTV); Electrophysiology (EP), references; Cardiology/Cardiovascular procedure privileges - general references; Internal Medicine Web Sites - useful for credentialing;

Hematology/Oncology; Neurology; Electrodiagnostic testing privileges; Neurosurgery; Nuclear Medicine: Nuclear Cardiology, I-131 Therapy;

Obstetrical/Gynecological: High-risk privileges; Obstetrical and Gynecological Ultrasound Examination Privileges; Laparoscopically Assisted Vaginal Hysterectomy, Colposcopy, Ophthalmology, Orthopedic Surgery, Otolaryngology/Head And Neck Surgery,

Pathology, Pediatrics, Core, Pediatrics, III, IV, V, , Physical Medicine and Rehabilitation, Plastic and Reconstructive Surgery, Podiatry,

Behavioral Health Care Credentialing & Privileges: Psychiatry, Psychology, Psychotherapist, Medical Hypnosis/Hypnotherapy Privileges, Addiction Specialist; Biofeedback Privileges, Neuropsychological Testing Privileges, Therapy: Family and/or Marital Privileges for Psychology,

Radiation Oncology/Therapeutic Radiology, Diagnostic Radiology (Criteria for Ultrasound Imaging, Discography, Core-Cut Breast Biopsy Privileges, MRI, Neuroradiologic Procedures, Neuroradiology Facility, Renal and Visceral Transluminal Angioplasty and Vascular Stenting, Peripheral and Visceral Arteriography, Arteriography/Angioplasty Facility, Percutaneous

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