Required Documents (Part 2) Why are they important?

Specialty Board Certificate(s) – Several MPR participating health care facilities require board certification or eligibility to be considered for staff membership/clinical privileges.  These documents provide the basic information needed to primary source verify a provider’s specialty board certification.

Line Listing of Current Continuing Medical Education (CME) Courses – The CME listing is not required by credentialing surveyors, but is preferred to copies of the certificates of attendance at various CE activities.  The surveyors will open the credentials file and place the line listing of CMEs with the privileges requested and approved for the provider.  The CME listing is used to verify a provider is attending courses that are directly related to the privileges requested.  Although CMEs are requested from providers at the time of licensure and re-licensure, they are necessary for the credentialing process to document current clinical competency to the privileges requested at the time of initial appointment and reappointment to the staff.

Military Discharge Papers – The DD 214 has become the standard document for proof of military experience.  Although the DD 214 is requested at the time of initial appointment, it is also the responsibility of MPR to primary source verify military experience with the National Personnel Records Center.  Both the DD 214 provided by the applicant and the primary source verification of the document are provided to the participating health care facilities in the completed credential file.

Current Alien Registration Card/VISA – The credentialing process requires documentation of the current VISA status.  A copy of the card is requested at the time of initial appointment and included in the completed credentialing file to the participating health care facility.

Residency Log of Procedures – It is the responsibility of MPR to document current clinical competency.  A listing of procedures performed during residency of graduates making application for initial appointment within one year of graduation from a residency program provides the necessary documentation for current clinical competency in the procedures requested.  The participating health care facility will determine if the number of procedures listed meets the facility-specific requirements to meet the definition of current clinical competency in the privileges requested.

Government Issued Photo ID – The credentialing standards require MPR to verify a provider’s ID through a government-issued photo ID (driver’s license, passport or military ID).  To meet this standard, we ask questions on both the hospital affiliation requests and professional references that allow the respondent to verify the person they are completing the verification on is the same person depicted in the photo attached to the request.  We are often asked if information can be redacted from the photo ID.  In addition to the photo of the applicant, there are three required data elements on the photo ID:  1) name of government agency (i.e, Kansas Department of Revenue), name of provider and date of birth.  All other information can be redacted from any government-issued photo ID.

Note:  Other photos are also requested from the provider (1 for each participating health care facility for which the applicant is applying) to include in facility or organization directories.

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