Your first order of business is to prepare a file that contains your personal paperwork pertaining to your training and state competency. In order to become a participating provider in any insurance plan or to gain and maintain your hospital privileges, you will need constant access to this information.
The Medical Staff Office at your affiliated hospitals will remind you when relevant certificates expire and most hospitals will deny you consulting and admitting privileges if these documents are not covered. Your participation in insurance plans will require you to re-credential every 12 months, so it is necessary and time saving to have the following documents on hand.
* You can either scan these documents into your computer, or create a paper file. I have used both methods to retrieve documents and I have found that a paper file ultimately afforded more efficient control over the multiple documents required.
If you or your Practice Administrator is dealing with a multiple physician practice, the outside of each folder should be marked with the following: Physician Name, Address, Phone (home and mobile), Date of Birth, Social Security Number, Marital Status, Name of Spouse, Emergency Contact number. You may also include the dates of completion of college, medical school, internship, residency and fellowship.
You will need the following documents :
1. Curriculum Vitae - It is a good idea to update your C.V. on an annual basis. You can use the anniversary date of your employment to update your personal information and CME credits. Make sure that your address and phone number are current. Always include the start and end dates for graduation from college, medical school, internship, residency, and fellowships. These dates will be required for most, if not all, hospital and insurance affiliations.
2. IRS Certificate assigning your Tax ID number - Medicare and most insurers will request a copy of this certificate before completing credentialing.
3. W-9 - Include and annual W-9 showing your business name and Tax ID number. Make sure this document is signed and dated properly.
4. Current State Registration - To register for your state license or to renew an existing license online, contact your State Education Department.
5. DEA Certificate - For a new application or to renew your existing certificate online, go to :
www.deadivison.usdoj.gov. The instructions are easy to follow and payment for renewal can be made by credit or debit card.
6. Malpractice Coverage - Make sure your factsheet for coverage contains the name, address, and phone number of the company providing your coverage.
In addition to the above, you will need copies of the following certifications:
Medical School Diploma
Internship Certification
Residency Certification
Fellowship Certification
Board Certification in Internal Medicine
Board Certification in Specialty if applicable
Your file should contain :
National Provider Identification Certificate - You must retain a copy of the original certificate from NPI showing your assigned number. https://nppes.cms.hhs.gov will allow you to search for a specific physician NPI number and will direct you to a site for obtaining an NPI number for the first time user.
Infection Control Certificate - Online certificates are offered via short course and exam. Your state nursing associations offer a variety of online courses that cam be completed in less than two hours. You will be able to pay for the course via credit or debit card, and upon completion, you will be prompted to print out your certificate.
ACLS Certification - Your affiliated hospital may require this certificate. The American Heart Association offers online courses, where providers are given a combined 32 hours to complete the program. Most doctors are able to complete the entire coursework in 3 to 4 hours. A skill testing session is also required. www.actnt.com/ACLSAnywhere.htm will direct you to the American Heart Association course.
CLIA Certification - Clinical Laboratory Improvement Amendments state all entities that perform even one test - including waived tests - on materials derived from the human body for purposes of diagnosis, prevention, or treatment of any disease or for the general assessment of health are in essence considered a laboratory and must meet certain Federal guidelines. The CLIA application collects information regarding a laboratory's operation. Applications for a CLIA Certificate can be found online at:
http://www.cms.hhs.gov/forms/cms116.pdf
Hospital Privileges - Letters from your affiliated hospitals noting the date and type of privileges should be included in your personal file and updated as the terms and dates for these arrangements are modified or ended.
Continuing Medical Education Credits - ( CME ) Your affiliated hospitals and some insurance companies will require that your complete a number of CME credits each year. Many courses are available online. You may also check with drug companies or medical equipment suppliers. They may be able to offer you CME's for attending seminars or meetings.
Insurance Affiliations - This file should contain your acceptance letters as a participating provider for both Medicare and private insurance plans.
You will be amazed at how many times you will need to access this file each year. Having this information readily available saves time and will assure that your credentialing process runs smoothly.
Tomorrow : Navigating the Crazy World of Insurance...
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