Verify & Comply: Credentialing, Medical Staff, and Ambulatory Care Standards, 8th Edition

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Verify & Comply: Credentialing, Medical Staff, and Ambulatory Care Standards, 8th Edition

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Available April 2020

Verify & Comply: Credentialing, Medical Staff, and Ambulatory Care Standards, 8th Edition


Available April 2020

Get the latest version of the medical staff industry’s most trusted compliance manual.

Celebrated by medical staff and credentialing professionals for over 15 years, Verify & Comply: Credentialing, Medical Staff, and Ambulatory Care Standards, 8th Edition, is one of HCPro’s most popular credentialing and accreditation resources. Credentialing and medical staff standards and regulations are covered in one easy-to-navigate side-by-side crosswalk, giving MSPs one book that answers all their accreditation questions.

Updated for 2020, 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. This book allows you to compare what each accreditor states about initial appointment, reappointment, and other medical staff functions, and provides tips and best practices to help you meet the most challenging standards. 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: 

  • Streamline and structure your medical staff and its responsibilities
  • Implement best practices in your medical staff services department that ensure compliance with your accreditor’s standards
  • Determine which verifications are necessary to obtain in the credentialing process
  • Understand the differences between the appointment, reappointment, and ongoing assessment stages of the credentialing process
  • Determine the appropriate areas in medical staff governance documentation to include specific items required by accreditation standards and regulations
  • Adopt best practices for complying with telemedicine and ambulatory accreditation standards


Available: April 2020

Page count: 318
Dimensions: 8.5” X 11”
ISBN: 978-1-68308-958-2

About the Authors

Stephanie Russell, BS, CPMSM, CPCS, is the regional director of medical staff services and credentialing at UCHealth in Colorado Springs, Colorado.  She has been an executive medical staff services professional for over 30 years, overseeing medical education, graduate medical education, bylaws, regulatory compliance and accreditation, health system credentialing for both hospitals and health plans, credentialing service contracts for outside entities, as well as delegation agreements and audits. Russell is a NAMSS instructor and has made many presentations at state and national educational conferences on topics related to credentialing, privileging, professional development, and regulatory compliance for both NCQA and The Joint Commission.  She has also been a collaborator and coach with Team Med Global since its inception, expanding her teachings to include practice management, managed care, and quality for medical staffs and hospitals. Russell was instrumental in creating the NAMSS course on Leadership, teaching the course the first two years it was offered by NAMSS.  She co-authored the seventh edition of Verify and Comply, Credentialing, Medical Staff and Ambulatory Care Standards.

Janet Wilson, CPMSM, CPCS, has been involved in the medical staff services, quality, and credentialing industry for the past 30 years. Her healthcare experience extends to hospitals, quality, managed care, and the CVO environment. Wilson is currently the Central Texas Division Director of Medical Staff Affairs and CVO of Baylor Scott & White Health. Wilson holds a Bachelor of Science in Health Administration and is CPMSM and CPCS certified by NAMSS. Wilson served for three years on the board of directors of NAMSS. Wilson also served on the board of directors of the Texas Society for Medical Services Specialists and served as president during her tenure on the board. Wilson has also been an independent educator and consultant  for over 14 years in the areas of credentialing, CVO, quality and medical staff services, with a primary focus on bylaws revisions, privilege form development, medical staff leadership education programs, and development and standardization of policies and procedures/documents across multiple hospital settings. Wilson has taught onsite and virtual CPMSM/CPCS certification study groups and professional development courses for over 14 years. In 2012, Wilson developed and launched a Certification Focused Study Program and teaches the Certification Program exclusively for EDGE-U-CATE, LLC., and is member of their faculty. She also assists in teaching EDGE-U-CATE’s Credentialing School.

Table of Contents:

Section 1: Acute Care & Managed Care: Credentialing Standards

  • Chapter 1: Initial Appointment, Clinical Privileges, and Credentialing
  • Chapter 2: Reappointment, Renewal/Reappraisal of Clinical Privileges, and Recredentialing
  • Chapter 3: Other Credentialing Aspects


Section 2: Medical Staff Acute Care Hospital Standards Not Related to Credentialing

  • Chapter 4: Medical Staff Structure, Bylaws, and Involvement in Organizational Leadership Functions and Required Committees
  • Chapter 5: Oversight of Patient Care, Treatment, and Services and Performance Improvement
  • Chapter 6: Medical Staff Involvement in Patient-Focused Areas and Patient Therapeutic Services


Section 3: Ambulatory Care: Credentialing Standards

  • Chapter 7: Initial Appointment, Reappointment, Clinical Privileges, Credentialing, and Recredentialing
  • Chapter 8: Other Credentialing Aspects