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How does the hospital privileging process work?

If it is your first time seeking approval from a Wisconsin hospital credentialing committee, you probably have many questions about the process. Unfortunately, it might be difficult for you to find a concise, general answer to any questions you have. Individual governing bodies have a great deal of latitude in deciding who works in their healthcare centers, and in what capacity.

Similar to many elements of professional medical practice, obtaining your privilege to work at a hospital involves a peer review process. Generally speaking, you could expect to present your qualifications and background information to a board of fellow physicians, specialists and medical administrators. You could be approved to practice at the facility once you pass this process, barring any one of many possible complications.

State health care law is probably responsible for some of the complexity involved in hospital privileging. For example, any institution in Wisconsin could grant the privilege to provide patient care on any number of bases to a broad range of medical professionals:

  • Nurse anesthetists
  • Dental practitioners
  • Chiropractors
  • LCSWs

According to the Department of Health & Human Services Centers for Medicare and Medicaid Services requirements on the subject, your review board should assess all of your abilities, insofar as those abilities relate to the activities you would perform during patient care. As such, you should expect a rigorous inspection of your professional capacity.

Your process could still be far from transparent, regardless of the fact that CMS regulations require hospitals to include their privileging criteria in their governing documents. If you were to experience complications that you could not readily justify through the terms of the guidelines delineated in the hospital's by-laws or the CMS Conditions of Participation, there could be less-legitimate forces at work. This is not legal advice. It is simply an introduction to the subject.

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