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NOTICE

We have just received a request from your office to provide a reference for the following physician who was formerly affiliated with this hospital:

Physician Name:
Because of the large number of such requests and the increasing expenses of handling them, we regret that a processing fee of $35.00 per form will be required.

Normally, such forms are completed within ten working days after receipt of payment. If expedited processing (three to five business days) is required, then a $15.00 surcharge (total $50.00) should also be remitted.

Please send your payment in the form of a check in the amount of $35.00 (or $50.00) made payable to ____________________. The physician's name should be noted on the check.

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Recent court cases and new Joint Commission requirements have raised the stakes – and the workload – for hospitals when responding to credentialing inquiries. When a hospital sent us this notice, we knew it was time to rethink the credentialing verification process.

On one hand, most medical staff offices do not have the time or resources to respond in detail to all credentialing inquiries from other hospitals, managed care organizations and health plans. Apparently, that's what led to the above notice.

On the other hand, an inaccurate or incomplete response could lead to liability, as demonstrated by Kadlec Medical Center v. Lakeview Anesthesia Associates and the very recent case of Estate of Fazaldin v. Englewood Hospital & Medical Center. In Kadlec, the jury found that “negligent misrepresentations” about an impaired anesthesiologist by his former partners and a Louisiana hospital in references to an inquiring hospital were a proximate cause of a patient in Washington state ending up in a permanent vegetative state after a routine surgical procedure due to the anesthesiologist’s gross negligence and the fact that he was impaired by drugs during the surgery.

In Fazaldin, the estate of a patient who died following a radical hysterectomy sued the hospital where the surgeon had previously practiced and the surgeon's department chair at that hospital, alleging that their failure to provide accurate information about the physician's resignation of clinical privileges and to report the physician's resignation to the state Department of Health and the federal National Practitioner Data Bank let the surgeon being granted privileges at the hospital where the surgery took place.

So what's a hospital to do? Join Barbara Blackmond and Phil Zarone, attorneys at Horty Springer, as they discuss strategies and policy guidelines for striking the right balance between promoting the provision of candid, accurate information, while conserving valuable resources of physician leaders and medical staff professionals.

Specifically, Barb and Phil discuss:

What information can and should be provided if the individual about whom information is requested has been the subject of formal adverse action?

What about lesser steps such as focused review, conditions of professional conduct, and performance improvement plans? Isn't that information that most Medical Staff leaders would like to know about an applicant for appointment or reappointment?

Can hospitals rely on the general release provided with a credentialing inquiry?

What if the hospital has entered into a settlement agreement with a physician specifying the manner in which credentialing inquiries will be handled? Does the settlement agreement trump the hospital's obligations under Kadlec?

Can hospitals in a system – or even unaffiliated hospitals in a community – develop efficient ways to exchange information for reappointment verification for practitioners on multiple staffs without risking a waiver of state peer review protection?

How should hospitals develop alternative, standardized communications to fit the most common situations?

Can hospitals take advantage of technology that allows a secure website to be used by credentialers at other hospitals to obtain verification for the majority of applicants?

What should hospitals do if they receive a request for payment for a reference inquiry?

What implications will the Fazaldin case have for credentialing?

Audio CD/MP3: $225

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Questions? Contact us via E-mail or call 1-800-245-1205