Credentialing has changed a lot over the years.  What started as a mere assessment of the most basic qualifications (e.g., “licensure, clinical competence, excellent reputation and the personal recommendation of an existing member of the active medical staff”) has morphed into an extensive process that shepherds candidates through several layers of review where they are measured by colleagues against a multitude of factors.

Training Highlights:

Participants will gain a thorough understanding of credentialing fundamentals, starting from the initial contact with potential new medical staff members or recruits, through to final hiring decisions or actions on appointments and privileges. The training will also cover the process of getting new staff credentialed by payors, if applicable.

Key Topics Include:

• Credentialing Continuum: From first contact to final hiring and credentialing by payors.
• Eligibility Criteria: Detailed exploration of eligibility requirements and administrative determinations.
• Waivers and Exceptions: Understanding when and how to apply waivers and exceptions to eligibility criteria.
• Handling Misrepresentations: Strategies for addressing misrepresentations in applications.
• Substantive Review: In-depth review of additional qualifications and special considerations during reappointment.

By the end of the Pathways Training Program, participants will be well-prepared to navigate the complexities of credentialing, ensuring both patient safety and practitioner support.