Credential Ing
Credential Ing
The process of obtaining, verifying and assessing the qualification of Licensed independent practitioner to determine whether he or she is qualified and able to provide patient care services in or for a health care organization. The obtain and verify portions of credentialing are mostly administrative in nature and can be performed by a medical staff coordinator. The assessment of qualifications must be done by an Licensed independent practitioner equivalent of the rank of Medical Director / Head of Department. Once credentiated, an applicant can be recommended for appointment to the medical staff.
Privileging
Privileging accompanies credentialing. Privileging is a process by which health care organization authorizes healthcare practitioner to perform specific patient care services related to his specialty. Credentialing and privileging ensures medical quality.
Credential Committee
Members : 1. Managing Trustee 2. CEO 3. Medical Director 4. Senior Medical Advisor
Steps of Credentialing
1. Committee to decide the need of consultant in the particular speciality 2. Doctor seeking attachment to the hospital fills the Credentialing form giving details of his qualification and work experience 3.Medical Director/ Head of Department verify the details from the University/ Medical Council 4. Reference check is also done by communicating with senior professional from whom the candidate is trained.
Benefits of Credentialing
1. Provides efficient and quality patient care. 2. Protects the patient from unqualified practitioner 3. Protects the hospital from accusation of negligence 4. Objective evaluation to provide particular services or to perform particular procedure.
MARITAL STATUS_______________________ NATIONALITY___________________________ PAN CARD NO_____________________________ AREA/ DISCIPLINE / SPECIALTY________________ PERMANENT ADDRESS__________________________________ ________________________________________________________ CORRESPONDENCE ADDRESS____________________________ ________________________________________________________ TELEPHONE : OFFICE ____________ MOBILE____________ EMAIL ID _______________________________ WHETHER PREVIOUSLY APPLIED : IF YES, WHEN YES/NO
_________________________________ ______________________________
2. PROFESSIONAL QUALIFICATION DIPLOMA/DEGREE/ UNIVERSITY/ YEAR OF PERCENTAGE NO OF MASTERS COLLEGE PASSING OF MARKS ATTEMPT
(Please attach certified copies of any qualifications detailed in the form) 3. OTHER TRAINING COURSES TYPE OF TRAINING INSTITUTION DURATION (MONTHS) YEAR
4. WORKING EXPERIENCE POSITION HELD INSTITUTION/ DURATION ORGANIZATION YEAR SALARY DRAWN
5. CONTINUING EDUCATION ( Relevant education seminars, courses, etc attended within last 3 years. Attach document that will support application)
6. REGISTRATION MEDICAL COUNCIL OF INDIA _____________________ MAHARASHTRA MEDICAL/ NURSING/ PHYSIOTHERAPIST/ TECHNICIANS COUNCIL __________________________________
7. PLEASE LIST AT LEAST TWO REFREES FAMILIAR WITH YOUR CLINICAL SKILLS ____________________________________________________________ ____________________________________________________________ 8. ANY MALPRACTISE SUITE IN COURT OF LAW 9. ANY CASE OF MEDICAL NEGLIGENCE YES/ NO YES/NO
I hereby declare that all the information given herein are true and correct
____________________________________ ____________________________________
PERMANENT ADDRESS
CORRESPONDENCE ADDRESS
TELEPHONE : RESIDENCE ___ _________ MOBILE_______ EMAIL ID STAFF POSITION CONSULTANT RESIDENT TECHNICIAN SENIOR RESIDENT NURSING PHYSIOTHERAPIST ____________________________________
2. PROFESSIONAL QUALIFICATION DIPLOMA/DEGREE/ UNIVERSITY/ YEAR OF PERCENTAGE NO OF MASTERS COLLEGE PASSING OF MARKS ATTEMPT
(Please attach certified copies of any qualifications detailed in the form) 3. OTHER TRAINING COURSES TYPE OF TRAINING INSTITUTION DURATION (MONTHS) YEAR
4. WORKING EXPERIENCE POSITION HELD INSTITUTION/ DURATION ORGANIZATION YEAR SALARY DRAWN
5. CONTINUING EDUCATION ( Relevant education seminars, courses, etc attended within last 3 years. Attach document that will support application)
7. PLEASE LIST AT LEAST TWO REFREES FAMILIAR WITH YOUR CLINICAL SKILLS
YES/ NO
YES/NO
I request approval for the Clinical Privileges indicated below for the period of ______ to ________ ( please indicate date). I certify that the information provided on this application is complete and accurate.
i. Core privileges ( Broad area ) ii. Special privileges ( in area) iii. Others e g. Research
Have the privileges you are requesting been granted to you at your previous place of employment? YES If yes , please specify, NO
I hereby declare that all the information given herein are true and correct
The education, training and / or experience identified, support this assertion of competence in privileges requested. This education, training and / or experience have been verified with the primary source, see attached.
Signature: ________________
Date: _________