Q: What is credentialing?
A: Credentialing is a term that usually encompasses two separate processes: credentialing and privileging.
- Credentialing: Primary source verification of a healthcare practitioner’s education, training, work experience, license, etc. A variety of resources are used to verify the information involving direct communication from the educational and training institutions, past and current hospital affiliations and employers, peer reference letters, certification boards, licensing agencies and other sources.
- Privileging: Granting approval for an individual to perform a specific procedure or specific set of privileges based on documented competence in the specialty in which privileges are requested.
Q: Who is credentialed?
A: Each practitioner working in the hospital or PeaceHealth Medical Group clinic setting must be credentialed through PeaceHealth St. Joseph Medical Center’s medical staff process.
Practitioners who are independently responsible for patient care by virtue of their license and hospital authority must be credentialed even if they are employed by PeaceHealth. Licensed independent practitioners who must be credentialed regardless of whether they are PeaceHealth employees or not are physicians, dentists, certified nurse midwives, podiatrists, nurse practitioners, physician assistants and psychologists.
Q: Why does PeaceHealth St. Joseph Medical Center credential?
A: PeaceHealth, like other healthcare organizations, is legally responsible for knowing that individuals providing patient care are qualified and competent to do so. Over the past 30 years there have been multiple legal cases where hospitals were held accountable because they had not done adequate credentialing.
The Joint Commission, the Centers for Medicare and Medicaid Services (CMS), National Committee on Quality Assurance (NCQA), Washington State Department of Health and other oversight organizations require that members of the medical and allied health staff be credentialed and privileged before working in the facility.
Q: Can a physician or other practitioner work at PeaceHealth St. Joseph Medical Center before completing the credentialing process?
A: No. It is PeaceHealth’s legal obligation to ensure that all practitioners have gone through the credentialing process and have been approved by the regional Board of Directors. A practitioner working at a PeaceHealth entity before the credentialing process is complete places PeaceHealth and the practitioner at significant legal risk and can directly impact accreditation status.
Q: How does a practitioner get credentialed and request privileges at PeaceHealth St. Joseph Medical Center?
Q: Does PeaceHealth require an application fee?
A: Initial applications require a fee of $350.00. Payment may be made by check and must be received by the PeaceHealth St. Joseph Medical Center Medical Staff Services office before the application is processed.
Q: What is The Joint Commission?
A: The Joint Commission is an accrediting organization with a mission to improve the safety and quality of care provided to the public. Hospitals voluntarily submit to the Joint Commission accreditation surveys every three years; the survey is a comprehensive evaluation of the overall quality and safety of the organization. PeaceHealth complies with all of the Joint Commission credentialing standards.