by Anne Roberts
Anne Roberts, CPMSM, CPCS, is the director of medical affairs at Children's Medical Center of Dallas, where she oversees the medical administration, graduate medical education, and medical staff services departments.

A common question from the field that we medical staff consultants often hear is what can be done to expedite the credentialing process? Physician leaders, administrators and applicants all want to know how to streamline the process and ensure a quick turnaround time for processing applications and granting clinical privileges.

For Joint Commission-accredited facilities, the standards allow the governing body to conduct an expedited approval process for initial and reappointment applicants when criteria for the expedited process (as established by the organized medical staff) is met. The first step in implementing this expedited process is to develop a policy. The policy should outline the criteria that applicants must meet in order for the governing body to grant expedited membership and/or clinical privileges. The criteria should also state that an applicant is ineligible for the expedited process if one of the following issues occur:

• The applicant submitted an incomplete application
• The medical executive committee makes a recommendation that is adverse or has limitations

Some organizations choose to add the following issues to their policy as automatically disqualifying an applicant for expedited processing. However, Joint Commission standards simply indicate that these issues must be reviewed on a case by case basis and will usually result in ineligibility:

• There is a current challenge or a previously successful challenge to licensure or registration
• The applicant has received an involuntary termination of medical staff membership at another hospital
• The applicant has received involuntary limitation, reduction, denial, or loss of clinical privileges
• The hospital determines that there has been either an unusual pattern of, or an excessive number of, professional liability actions resulting in a final judgment against the applicant

The Joint Commission standards indicate that the governing body may delegate some decision making responsibilities to a committee of at least two voting members of the governing body. These responsibilities include the authority to render decisions to grant initial appointments, reappointments, clinical privileges or modify clinical privileges.

Many locum tenens often question whether or not their credentialing and privileging can be “expedited” or “fast tracked.” As these standards only apply to expediting the governing body approval, they do not waive the requirement for organizations to follow their credentialing and privileging policies. While the committee approval process can be expedited, the process for credentialing remains unchanged. Organizations can send applicants or administrative leaders a copy of their credentialing, privileging, and expedited approval process policies to help clarify questions.

Looking for more information about how the credentialing process works? Check out the Credentialing Resource Center blog at www.credentialingresourcecenter.com/blog.