Credentialing Process - Cook County Health

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Credentialing Process Medical Staff Services Department October 23, 2020

Initial Appointment and Reappointment (Every 2 years) Medical Staff Bylaws/Joint Commission/National Commission of Quality Assurance (NCQA) § Initial Appointment – Candidate accepts employment offer: § Clinical Department Chair submits a Release of Application form to MSSD for processing (Initial Appointment only) § Applicant/Reapplicant submits application including CCH credentialing supplemental forms: Mandated State of IL Credentialing/Recredentialing Application (signature of attestation statement indicates all information on the State of Illinois form is correct with full disclosure of adverse actions) Consent and Release Form Supplemental Form (additional demographic information and disclosures) Clinical Privilege Form (specialty of clinical patient care) APRNs and PAs (Collaborating Physician is required) Government Photo ID (initial applicant) 2

Credentialing Application Process Data Collection and Primary Source Verification (PSV) Morrissey Software On the Web (MSOW credentialing Software) –Data Entry from Application Primary Source Verification (PSV) is queried directly from the organization (Red Flags identified): State of IL License/Controlled Substance DEA Certificate Federal/State OIG Board Certification Opt Out (Medicare) National Practitioner Data Bank AMA/AOA Profile NPI Malpractice Insurance/Claims History SAM (Federal Sanctions) Peer References Social Security Death Masterfile Education/Training (Medical School/Residency/Fellowship/Initial Applicants) Reappointment (other Residency or Fellowship) Hospital Affiliations (present and past) 3

Credentialing File Approval Process Complete file includes all PSV and Required Application & Supplemental Forms üDepartment Chair Review/Approval üNon-Physician Provider Committee for Recommendation (PAs, APNs, LCSW ) ü Credentials Committee for Recommendation üCredentials Committee Recommendations to Executive Medical Staff (EMS)/Medical Executive Committee (MEC) üEMS/MEC presentation of Recommendation to Quality and Patient Safety Board (QPS) QPS is final approval of clinical privileges. The practitioner receives letter of QPS Board approval from MSSD and this triggers Human Resources Onboarding. 4

Closing of QPS Approved Files Process Completed file: MSOW software updated with approval dates (Initial Appointment/Reappointment) ü Credentials Committee Approval Date ü QPS Approval Date ü All documentation with required approval signatures ü All PSV ü Board Approval Letter ü Completed file scanned into MSOW 5

Breakdown of Credentialed Practitioners Credentialed Practitioners Physicians, 793, 77% NPPs, 243, 23% PHYSICIANS NPPs MD - 713 PA-C - 78 DO - 47 APRN - 69 DDS - 21 Clinical Psychologists - 32 DMD – 8 Social Worker - 29 DPM - 4 Certified Registered Nurse Anesthetists - 13 Perfusionists - 8 Dental Hygienists - 6 Optometrists - 4 Genetic Counselor - 1 Physicians NPPs 6

Thank you.

Credentialing Application Process Morrissey Software On the Web (MSOW credentialing Software) -Data Entry from Application Primary Source Verification (PSV) is queried directly from the organization (Red Flags identified): State of IL License/Controlled Substance DEA Certificate Federal/State OIG Board Certification

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