PMH board hears about medical credentialing

How well do you really know your doctor? Have you seen his medical school diploma? How do you know if your doctor’s license has been revoked? Is your doctor qualified to be performing a particular procedure on you?

At Pocahontas Memorial Hospital, staff members make sure that medical service providers are licensed and qualified to perform their jobs. The highlight of May’s Board of Trustee’s meeting was a presentation by Ernestine Pollard on PMH’s credentialing and privileging process.

Pollard explained that credentialing is the process of validating the qualifications and competence of a licensed medical practitioner. Privileging is the process used to determine the specific procedures and treatments each health care provider may perform.

Pollard said her department is responsible for collecting and verifying documentation of a provider’s educational and professional certifications. The documentation includes records such as medical school diplomas, internship and residency certificates, current state medical licenses and liability insurance records. When a provider applies to work at PMH, staff members review the records and verify a provider’s past and present hospital affiliations. They also verify all licenses with state licensing boards.

“We can never assume someone else has done the work for us,” she said.

After collecting and verifying a provider’s documentation, the PMH Credentialing Department forwards an application to the Medical Executive Committee. The Medical Executive Committee reviews the application and makes a recommendation to the Board of Trustees.

The Board of Trustees is ultimately responsible for granting or denying membership and privileges. Pollard told the board that the need for a provider should never justify lowering standards or rushing the credentialing process.

“The quality of the provider’s work and patient satisfaction with him or her is the most critical component of the hospital’s success,” she said.

Pollard said all medical service providers must be re-credentialed every two years. She concluded by reminding the board that the hospital and even individual board members could be held liable if an incompetent provider was hired.

State licensing boards provide public information on a doctor’s license status and disciplinary action. The West Virginia Board of Medicine licensee search can be found at www.wvbom.wv.gov. The West Virginia Board of Osteopathic Medicine licensee search can be found at www.wvbdosteo.org.

Following Pollard’s briefing, the board heard updates from various departments.

Chief Financial Officer Melissa Kane reported a loss of $84,335 for April, the first monthly loss in the calendar year. The hospital maintains a profit of $1.8 million for the fiscal year.

Kane said April is normally the slowest month for the hospital, financially.

The board approved write-offs of bad debt totaling $78,137. The hospital received 31 new applications for debt exoneration totaling $33,623.

Board chairman Dr. Robert Must asked Kane if less money is being lost to bad debt.

“We may have less money lost to exonerations because more people will be having insurance,” he said. “Is that what you’re seeing?”

“We’re seeing, if they’re not approved for Medicaid, they are becoming insured through other programs with the Affordable Care Act,” said Kane. “But a lot of them have met the credentialing for the expanded Medicaid.”

In other business, the board unanimously approved a $500 donation to the Marlinton Fire Department.

The next meeting of the PMH board is scheduled for Thursday, June 19 at 6 p.m.

 

 

 

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