Whitaker Medical Staff Credentialing Process

A. Receiving the Locum Packet

Each potential candidate we recruit is sent a Locum Packet to apply with our company. Here is the process it follows once received & completed:

1. All primary source verifications begin following a combination of NCQA & JCAHO standards.
2. If the file meets the following criteria the file is submitted to insurance for review and approval:
• Claim Severity: Any claim that is settled for more than $150,000.00 on applicant's behalf in the past 5 years.
• Claim Frequency: 2 or more claims within the past 5 years that have settled for any amount. This does not apply to non-suit or dismissed claims.
3. A file can be declined for the following reasons:
• Excessive claims history or claim severity
• Not providing poof of maintaining sobriety for at least 5 years
• Considered a risk/liability by the Quality Assurance Committee
• Negative feedback is gathered by the client, references or verifications obtained on applicant/candidate
• Inability to stay committed to an assignment

B. Required Primary Source Verifications for Whitaker Medical

Credentialing sends out all verification requests directly to the work history and schooling, if applicable, for each candidate. Other verifications are done on-line.

1. Highest degree of education verified by the school or Centralized Verification Organization (CVO). If the practitioner is Board Certified that will equate to the highest level of education and therefore be verified instead. All foreign graduates will be verified through the ECFMG.
2. Board Certification is verified through the State Medical Board or AMA Master Profile website. Past 10 years of work history verified through the facility directly by contacting the Medical Staff Office or the department of their specialty.
3. Any gaps in work history of 6 months or more on the CV are explained by the candidate in writing and then verified by our credentialing department.
4. Licensure (Active & Inactive are verified for every state either on-line or verbally with the appropriate State Medical Board.)
5. DEA (If applicable)-verified.
6. DPS (If applicable)-verified.
7. Past 5 years of malpractice insurance carriers verified directly through the carrier with the request of a loss run history report.
8. All malpractice claims history verified.

C. National Practitioner Data Bank (NPDB)

An On-Line Query is performed on each candidate for any malpractice history, state board reports/limitations on licensure and/or Medicare/Medicaid sanctions. This process is repeated every 2 years on active candidates or as needed.