Residency/Fellowship Training

Question 1

Joint Commission
Residency/Fellowship Training

Answer 1

At the time of appointment to membership and initial granting of privileges, verification of relevant training or experience must be obtained from the primary source/s or designated equivalent source.
In addition to contacting the primary source (training program) TJC allows use of the following designated equivalent sources:
- American Medical Association Physician Masterfile
- (AOA) Physician Database for postdoctoral education approved by the AOA Council on Postdoctoral Training

Question 2

NCQA
Residency/Fellowship Training`

Answer 2

The organization must only verify the highest level of credentials attained. For example, if a physician is board certified, verification of board certification meets this element because the specialty boards verify education and training.
(Verification of fellowship does not meet this requirement)
NCQA only recognizes residency programs that have been accredited by the ACGME, College of Family Physicians of Canada, or the Royal College of Physicians and Surgeons of Canada.
If not board certified, any of the following sources can be used to verify training:
- the primary source
- the state licensing agency or specialty board, or registry
- sealed transcripts may be accepted if the organization shows evidence that is inspected the contents of the envelope and confirmed the practitioner completed (graduated from) the appropriate training program.
Other acceptable sources for physicians are:
- AMA physician master file
- AMA American Osteopathic Association (AOA) physician master file
- Official osteopathic physician profile report or AOA physician master file
- FCVS for closed residency programs
- If the organization uses confirmation from a NCQA approved source, the organization must verify that the source performs PSV, and, at least annually, the organization must obtain a written confirmation from that approved source that it performs primary source verification
Time limit: must be verified prior to the credentialing decision

Question 3

ACHC
Residency/Fellowship Training

Answer 3

PSV includes direct contact withe program, AMA physicians profile, AOA official osteopathic physician profile. Need documentation regarding training and education sufficient to support requested privileges

Question 4

DNV

Answer 4

MS 6 SR a
Medical Staff bylaws describe the qualifications to be met by a candidate in order for the medical staff to recommend that the governing body appoint the candidate. Those qualifications shall include primary source verification of specific training. AMA/AOA Profile is acceptable.

Question 5

URAC
Residency/Fellowship Training

Answer 5

History of professional training must be included on the credentialing application.
Verify highest level of education/training (not required to verify education/training if board certification is verified.) PSV can include state licensing board, residency/training program.
An organization can rely on the verification activities of state licensing boards. If this is done, it should be noted in the credentials file.
Confirm that the state board does verify a credential before relying on the board.
Time limit - must be verified within 180 days of the credentialing decision.

Question 5

AAAHC
Residency/Fellowship Training

Answer 5

Relevant training verified with primary or secondary source on initial appointment

Question 5

Medicare
Residency/Fellowship Training

Answer 5

482.12(a)(6) and 482.22(c)(4)
The governing body must ensure that the criteria for selection of medical staff are individual character, competence, training, experience, and judgement.