The Guide to Credentialing and Privileging Telemedicine Providers

Whether you are adding telemedicine services to your organization or looking to improve current processes, The Guide to Credentialing and Privileging Telemedicine Providers is the MSP’s on-the-job manual for all aspects of telemedicine. Veteran MSPs Jodie Chant, MPA/HCA, BHSA, CPCS, RHIT, and Michelle Kelly, CPMSM, take a deep dive into the evolving world of remote medicine, providing tips and best practices for credentialing, privileging, and peer review of telemedicine providers as well as receiving reimbursement from payers.

In addition to sample policies and procedures, forms, and bylaws language, this book features case studies aimed at providing as much real-life, actionable guidance as possible. Perfect for new or seasoned MSPs, this guide breaks down fundamental telemedicine terminology used, outlines the different credentialing options for these providers, and provides methods for ensuring clinical competency. As telemedicine experiences unprecedented growth, it is more important than ever to ensure that your organization is prepared to handle these providers.

Published: January 2021

Pages: 148
Dimensions: 7” X 9” perfect bound
ISBN: 978-1-64535-063-7

Table of Contents

Chapter 1: The Fundamentals of Telemedicine

• History of Telemedicine
• Telehealth, Telecare, Telemedicine: What Is the Difference?
• Specialties Most Frequently Involved in Telemedicine
• Types of Telemedicine
• Benefits of Utilizing Telemedicine Services 
• Barriers to Implementing Telemedicine Services 
• HIPAA and Telemedicine 

Chapter 2: Credentialing and Privileging Telemedicine Practitioners

• Traditional Credentialing of Telemedicine Practitioners
• Case Study: Delegated Credentialing of Telemedicine Practitioners
• CMS and Accrediting Bodies
• Privileging Telemedicine Practitioners: How Is This Process Different from Privileging On-Site Practitioners?
• Case Study: Telemedicine Credentialing and Privileging Across a Health System
• Credentialing by Proxy
• Hybrid Traditional and Proxy Credentialing Models

Chapter 3: Telemedicine Agreements

• General Contractual Provisions for Telemedicine Agreements
• Technology and Confidentiality Considerations
• Professional Experience with Telemedicine Agreements
• Case Study: Entering into a Telemedicine Agreement

Chapter 4: Peer Review of Telemedicine Practitioners

• A Brief History of Peer Review
• Professional Practice Evaluation Policies and Procedures
• Focused Professional Practice Evaluation
  Ongoing Professional Practice Evaluation
• Gathering FPPE/OPPE Peer Review Data from the Originating Site
• Using FPPE and OPPE Data in Decision-Making

Chapter 5: Incorporating Telemedicine into Your Bylaws

• Sample Bylaws, Policy & Procedure Language: Peer Review

Chapter 6: Telemedicine and Payers

• Reimbursement Available from Medicare/Medicaid
• Reimbursement Available from Commercial Payers
• Case Study: Adding Telemedicine Services to a Practice
• The Future of Telemedicine Services
• Common Provider Issues Related to the Provision of Telemedicine Services

About the Authors

Jodie Chant¸ MPA/HCA, BHSA, CPCS, RHIT
Jodie Chant, MPA/HCA, BHSA, CPCS, RHIT, possesses more than 25 years of healthcare experience, including 20 years in administrative healthcare leadership in the acute care, managed care, clinically integrated network, physician organization, and physician hospital organization settings.  Chant is president, CEO, and founder of Chant Medical Staff Resources, LLC, headquartered in Laingsburg, Michigan.

Chant graduated from the University of Michigan with a Master of Public/Health Care Administration, holds undergraduate degrees in Health Science Administration and Applied Science, and is a former emergency medical technician (EMT). Chant is a Registered Health Information Technologist (RHIT), a Certified Provider Credentialing Specialist (CPCS), and a TeamSTEPPS Master Trainer. Chant has authored numerous publications and given presentations on a variety of credentialing, privileging, peer review, and physician/medical staff issues. 

Michelle Kelly, CPMSM
Michelle Kelly, CPMSM, possesses more than 37 years of healthcare experience, including 27 years as a medical staff services professional and 13 years in a medical staff services leadership role at McLaren Greater Lansing, an acute care hospital in Lansing, Michigan. Kelly is currently the credentials administrator with Chant Medical Staff Resources, LLC, headquartered in Laingsburg, Michigan, where she is responsible for management of initial credentialing, recredentialing, and a credentials database for multiple organizations, as well as the supervision of credentialing staff. 

Kelly graduated from Lansing Community College with an associate’s degree, emphasis in business, and is a Certified Professional Medical Services Management (CPMSM). She has provided interim leadership and organization to the credentialing program at a university physician practice as well as consultative services to the leadership team. Kelly served as the Michigan Association Medical Staff Services’ treasurer from 2006 to 2008 and president from 2010 to 2012.