Medical Malpractice News

The Hospital Credentialing Process and Doctors Medical Malpractice Insurance

Tags: | Comments: 0 | March 28th, 2011

Before any physician is given privileges to practice medicine at a hospital he/she must go through a lengthy credentialing process and be approved by a credentialing committee.  Although it is a lengthy process it not insurmountable and you will find that most hospitals outline all the steps up front and will provide help along the way.  It’s important to complete the application and paper work thoroughly and meet the deadlines given. Physicians and surgeons are required to have medical malpractice insurance in place effective the day that their privileges begin. This can be the lengthiest part of the process so it is important you apply for medical liability insurance coverage early.

Don’t Procrastinate with the Paperwork

The typical hospital credentialing process can take at least 90 days, so the sooner you get started, the sooner you will be approved.  The first thing to do is to fill out the credentialing packet provided by the medical staff office at the hospital.  Some hospitals have this packet available on line, which can make it a bit easier and quicker.  The credentialing packet usually includes an application, which will ask for educational background, training, license information, DEA registration, work history, any loss or suspension of license or hospital privileges, and peer references.  The hospital credentialing application is often 30 pages or more and it is important to complete the application thoroughly. Part of the credentialing application is to include detailed narratives of any medical malpractice insurance claims that a physician has had in the past. In addition, hospitals require loss runs, also known as claim histories, from all of the physicians past medical malpractice insurance companies to proof their claim history. Many hospitals use a universal application form so that physicians don’t have to repeat the same information when applying at multiple hospitals.  This is helpful due to the amount of information required for credentialing.

The Credentialing Application Process & the “Credentialing Committee”

Providing proof of an active medical malpractice insurance policy and the history of medical malpractice claims (if any) is one of the most important steps in credentialing.  The credentialing application will require the dates the claim was received by the physician, and the date that the claim was resolved with the medical malpractice insurance company. In addition a brief narrative describing the claims, if there are any open claims, and the outcome of any closed claims will need to be included.  The outcome of the medical malpractice insurance claim references whether the claim was dismissed, won at trial, or if there was an indemnity payment made. It has become easier and more convenient to obtain medical malpractice insurance coverage through such services as, eQuoteMD.  They can provide you with quotes from the best medical liability insurance companies with the lowest premium rates in any state.

Once the hospital credentialing application packet is submitted to the medical staff office it will be reviewed for completeness and all the information will be verified.  The medical staff office will contact references, look into medical malpractice insurance claims, and verify education and medical practice history.  This can take some time, but they will usually give you a good idea of how long it will take.  After this, the information is sent to the “Credentialing Committee,” which usually meets monthly.  This is yet another reason the deadlines are critical.  If you don’t get the packet submitted on time, it will delay the process for another month, or until the committee meets again.

Medical malpractice insurance underwriting can sometimes take several weeks to have you approved.

Once approved physicians will need to make a down payment for the premium in order to get the certificate of insurance. If you do not have the certificate of insurance by the deadline, you will have to wait another month before you are approved to work at that hospital. Hospital “Credentialing Committees” are made up of physicians and hospital administrators and it’s their job to cautiously screen and grant privileges to doctors.  Some hospitals even have a separate Privileges Committee that will approve and give privileges based on the Credentialing Committee’s recommendation.  This review is an important part of patient safety, and it also protects the hospital from potential problems.  After all, doctors are trusted to make life-changing decisions everyday.