dr. zanga power point
TRANSCRIPT
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Joseph Zanga, MD, FAAPChief of Pediatrics
Columbus Children’s HospitalColumbus, Georgia
Professor of Pediatrics - Mercer University School of Medicine
706 571 1220
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Credentialing Simplified
The
WHY and HOW
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Columbus, Georgia
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Columbus, Georgia
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Columbus, Georgia
Area: 220.8 sq. miles (571.9 km²)
Population: 202,824 (2013)
Second largest city (not metro) in Georgia
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Midtown Medical Center
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The Why
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Midtown Medical Center
• Columbus Children’s Hospital and the Community:
• 35 primary care pediatricians
• Pediatric Emergency Center (PEC)
• Regional perinatal center – 40 bassinettes
• 21 Inpatient beds
• 5 bed PICU
• 5 bed stepdown/observation unit
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We Have at the Hospital and in the Community:
• Neonatologists (3)• Allergist/immunologist• Cardiologist• Critical Care• Endocrinologist• Gastroenterologist• Hematologist/Oncologist• Neurologist• Ophthalmologist• Orthopedist• Psychiatrist• Physiatrist
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But We Still Needed
Services for:
PediatricNephrology
Urology
Child Maltreatment
Dermatology
And someone in every other service for which we had only one specialist
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So We Wanted
Backup in:Cardiology
Critical Care
ENT
Gastroenterology
Hepatology
PM&R
Psychiatry
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However No One Wanted To Complete Our 47 Page Credentialing Packet and Provide All The Accompanying Documentation Required (24 Separate Items – plus $100)
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The How
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Official Publication of Joint Commission Requirements Final
Telemedicine Revisions • Element of Performance for LD.04.03.09 A 23. For
hospitals that use Joint Commission accreditation for deemed status purposes:
• The originating site makes certain through the written agreement that all distant-site telemedicine providers’ credentialing and privileging processes meet, at a minimum, the Medicare Conditions of Participation at 42 CFR 482.12(a)(1) through (a)(9) and 482.22(a)(1) through (a)(4).
• If the originating site chooses to use the credentialing and privileging decision of the distant-site telemedicine provider, then the following requirements apply:
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• The governing body of the distant site is responsible for having a process that is consistent with the credentialing and privileging requirements in the “Medical Staff” (MS) chapter (For more information, see Standards MS.06.01.01 through MS.06.01.13).
• The governing body of the originating site grants privileges to a distant-site licensed independent practitioner based on the originating site’s medical staff recommendations, which rely on information provided by the distant site.
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There is Another Section
APPLICABLE TO CRITICAL
ACCESS HOSPITALS
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Medical Staff (MS) Standard
MS.13.01.01 For originating sites only: Licensed independent practitioners who are responsible for the care, treatment, and services of the patient via telemedicine link are subject to the credentialing and privileging processes of the originating site.
Element of Performance for MS.13.01.01
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The Next Step
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MMC Staff By-Laws
Telemedicine: Medical practice is defined as any contact that results in a written or documented medical opinion and affects the medical diagnosis or medical treatment of a patient.
Telemedicine is the practice medicine through the use of electronic communication or other communication technologies to provide or support clinical care at a distance.
The Joint Commission and the American Telemedicine Association define telemedicine as the use of medical information exchanged from one site to another via electronic communications for the health and education of the patient or healthcare provider and for the purpose of improving patient care, treatment and services
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• 3.2.1.1 If the applicant is a telemedicine Practitioner located in a different State the applicant must also possess current, unlimited, unrestricted, active licensure in that State as well as in Georgia.
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Telemedicine Privileges
Practitioners who wish to provide
telemedicine services, as defined in these
Bylaws… shall be required to apply for and
be granted clinical privileges for these
services as provided in these Bylaws
The Medical Staff shall define…which clinical
services are appropriately delivered through a
telemedicine medium…
The following credentialing procedures shall
be followed:
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• 5.2.11.1 When a telemedicine provider is providing services from a different State, licensure and/or other requirements that may be imposed by a State will be verified for both the State where the Hospital is located and the State where the Practitioner is located.
• 5.2.11.2 Specific to telemedicine providers, due to extraordinary high number of healthcare affiliations, queries will be limited to the top five high volume affiliations and any healthcare organization from which the Practitioner was reassigned during the last five years.
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With All That In Place
• Application received in Medical Staff Office
• If complete is referred to Pediatric Credentials Committee
• If approved:
Is referred to Medical Staff Credentialing
Committee
Then is referred to Medical Executive Committee
• Final approval is by the Board of Directors
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Remember
No One Wanted To Complete Our 47 Page Credentialing Packet and Provide All The Accompanying Documentation Required (24 Separate Items - plus $100)
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Credentialing By Proxy
• Copy of Health Care Facility (JACHO) approved delineation of privileges form for provider
• Provider Summary Page (to include educational background information)
• Certificate of Malpractice Insurance
• State License Verification
• DEA Verification
• Board Certification Verification
• CV
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So Now We Have
15 Telemedicine Physician Consultants on Call
Heavy Cardiology Concentration
Still need:
Dermatology
Infectious Disease
Rheumatology
??
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One Further Need
Funds
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Any Questions
Thank You