FEATURE


ing and provider enrollment for Athens Orthopedic Clinic's surgery centers in Athens and Loganville, Georgia. “In addition, the process is slowed when multiple requests for completion of a peer evaluation are necessary.”


Comprehend the Concepts An essential step Riegle recommends ASCs take to reduce the likelihood of deficiencies in credentialing, privileg- ing and peer review is to understand what the processes cover. Credentialing practitioner's


requires a education,


verifying training,


Avoid Credentialing, Privileging


and Peer Review Deficiencies Understand the requirements, keep current and use software to simplify processes BY ROBERT KURTZ


I


n its 2020 AAAHC Quality Road- map, the Accreditation Association


for Ambulatory Health Care identi- fies credentialing, privileging and peer review as high-deficiency standards for ASCs. That comes as no surprise says


Scott Riegle, partner and president of ASCistus Management


Resources,


based in Nashville, Tennessee. “Peo- ple often get these processes confused. Couple this with the busyness of a typical ASC and staff wearing a lot of different hats and it can be easy to become noncompliant with standards." For Lisa Rehill, credentialing coor-


dinator for Outpatient Surgery Center of Hilton Head in Hilton Head Island, South Carolina, the biggest hurdle to meeting standards is an incomplete credentialing


packet submitted by


applicants. “A lack of information, unsigned


documentation and miss- 12 ASC FOCUS APRIL 2021 | ascfocus.org


LEARN MORE DURING ASCA 2021


Find out more about credentialing and peer reviewing at the ASCA 2021 Virtual Conference during sessions such as “Implement a Meaningful, Effective and Compliant Peer Review Process,” “A Deep Dive into the Credentialing File” and “Negligent Credentialing: Traps and Resolutions.” The ASCA 2021 Virtual Conference takes place live on April 26, May 3 and May 10 and will be available on demand afterward.


ascassociation.org/ annualconference


ing certificates throw a wrench into a smooth credentialing process.” This sentiment is shared by Kris


Vinson, medical staff services coor- dinator who is tasked with credential-


medical licensure and board certifica- tions from a primary source to verify the practitioner is qualified and com- petent to exercise the clinical privi- leges requested by the individual. “Credentialing ensures that the prac- titioner's application is in compliance with accreditation and regulatory stan- dards,” Vinson says. Privileging is the process of verifying that the privileges requested by a prac- titioner are within the specific scope of practice for the practitioner's specialty. “The individual's credentials and perfor- mance are considered prior to granting clinical privileges,” Vinson says. Finally, peer review is a mecha- nism for evaluating a practitioner's quality of patient care and safety. “Separately, each process gives you a little insight into the individual apply- ing for privileges," Rehill says. "How- ever, together they paint a complete picture of the individual's education, training and surgical performance. The policies we have put in place help ensure that we meet and exceed mini- mum regulatory standards.” Such policies should align with your accreditor's standards, Riegle says. "Do your best not to overcompli- cate your policies. Put simple mecha- nisms in place that will help ensure you complete the core pieces required.” For example, Riegle says he regu-


larly sees ASCs overlook processes already in place that can support com-


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34