Verify and Comply: Credentialing and Medical Staff Standards Crosswalk, Sixth Edition

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Verify and Comply: Credentialing and Medical Staff Standards Crosswalk, Sixth Edition

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Verify and Comply: Credentialing and Medical Staff Standards Crosswalk, Sixth Edition

Carol S. Cairns, CPMSM, CPCS
Kathy Matzka, CPMSM, CPCS

Verify and Comply, Sixth Edition, includes both credentialing and medical staff standards and regulations in one easy-to-navigate manual, giving MSPs one book that answers all their accreditation questions.

This expanded guide includes ambulatory care, acute care, and managed care standards for the most popular regulators and accreditors: CMS, The Joint Commission, NCQA, DNV, HFAP, and AAAHC. From initial appointment to reappointment to medical staff functions, these standards are side by side in an easy-to-read grid. Use this resource to study for the NAMSS certification exam and to keep up to date with regulators’ and accreditors’ credentialing and medical staff standards.

This book will help you:

  • Understand the differences between the stages of the credentialing process: appointment, reappointment, and ongoing assessment
  • Determine which verifications are necessary to obtain in the credentialing process
  • Discuss the importance of having an organized medical staff
  • Define the structure of your medical staff and its responsibilities
  • Determine the appropriate area in medical staff governance documentation to include specific items required by accreditation standards and regulatory requirements
  • Explain your medical staff’s involvement in organizational leadership functions

This book includes downloadable resources that will help your organization ensure compliance through all the steps of the credentialing and medical staff membership process.

Meet the Authors:

Carol S. Cairns, CPMSM, CPCS:

Carol Cairns has been in the unique position of seeing and participating in the development of the medical staff services profession for more than 40 years. In 1996, she founded Plainfield, Illinois–based PRO-CON, a consulting firm specializing in credentialing, privileging, medical staff organization operations, and survey preparation.  In 1991, Cairns became clinical faculty for The Joint Commission by collaborating in the development of an educational program on credentialing and privileging medical staff and allied health professionals.  From 1996 to 2006, Cairns served the National Committee on Quality Assurance (NCQA) as a surveyor in the certification program for CVOs.  Cairns was invited by the American Osteopathic Association to provide input into the development of the medical staff and allied health professional standards for the 2005 Healthcare Facilities Accreditation Program Manual.

Kathy Matzka, CPMSM, CPCS

Kathy Matzka is a consultant and speaker with 25 years of experience in credentialing, privileging, and medical staff services. Matzka worked for 13 years as a hospital medical staff coordinator before venturing out on her own as an independent consultant, writer, and speaker.  She has performed extensive work with NAMSS’ library team, developing and editing educational materials related to the field, including CPCS and CPMSM certification exam preparatory courses; CPMSM and CPCS professional development workshops; and NAMSS core curriculum. She also serves as an instructor for NAMSS. Matzka is a highly regarded industry speaker, and in this role has developed and presented numerous programs for professional associations, hospitals, and hospital associations on a wide range of topics, including provider credentialing and privileging, medical staff meeting management, peer review, negligent credentialing, provider competency, and accreditation standards.

Published October 2014