The Credentialing process is a system for validating and evaluating the credentials and competencies of licensed and certified staff as a basis for employment, continued employment, or change in assignment.
Centro San Vicente has implemented a credentialing program to qualify for Federal Tort Claims Act (FTCA) liability coverage by credentialing their licensed and certified healthcare practitioners. While Joint Commission only requires licensed independent practitioners to be credentialed, the FTCA requires that all licensed and certified staff be credentialed and recredentialed for the services that they perform in the Center. The Medicaid program requires that staff be credentialed based on services performed.
In order for a person to be covered by the FTCA, the licensed or certified individual must be a licensed, certified, registered or contracted staff member of the Center and must provide services consistent with the funding contract of the Center.
During the credentialing process, the following documents will be reviewed, verified and validated.
After the credentialing process is complete, the Credentialing Specialist delivers an original verification of documents, along with a summary of findings, to the Credentialing Committee and Chief Executive Officer. All Licensed Independent Practitioners and findings are then presented to the Board of Directors via the Chief Executive Officer for Initial Appointment or Reappointment. Other licensed, registered or certified staff member’s summary of findings will be presented to the Credentialing Committee and Chief Executive Officer to approve or deny employment.
In order to maintain compliance with the Center, Joint Commission, FTCA, HRSA, Medicaid, Medicare and Managed Care contracts, current licensure must be maintained at all times.
It is the responsibility of the licensed, certified or registered employee to maintain their licensure current and present a copy of the renewed license to the Human Resource Department and the Credentialing Specialist.
Continuing education certificates must also be presented to the Credentialing Specialist, as received.
Recredentialing for all licensed, certified and registered staff is performed every two years.
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