What Olsten Health Services requires
As more health care providers set up guidelines according to those set by the Washington, DC-based National Committee on Quality Assurance (NCQA), national credentialing will become more common. (For more information about the credentialing committee, see related story, p. 88.) Here’s an overview of credentialing items required by Olsten Health Services (OHS) Network:Application.
All providers must complete the OHS network credentialing application. The application asks questions related to the credentials, operational, financial, and quality performance information as well as information related to types of services provided and service area. The application must contain a current signature of the CEO, administrator, or other appropriate designated representative, attesting that all information provided in conjunction with the application is true and correct.
Licensure.
Olsten requires current licensure in good standing in accordance with state statutes. Olsten obtains a copy of the current primary license under which the facility is operating.
Medicare/Medicaid sanctions.
Olsten verifies the presence of Medicare/ Medicaid sanctions against a provider by reviewing the most current copy of the Department of Health and Human Services Cumulative Sanction Report. If sanctions are present, then initial credentialing of the provider is ceased. If a provider is currently in the network and sanctions are found, the sanctions are grounds for termination from the network.
Proof of professional and general liability insurance.
Each provider must carry general and professional liability coverage. Coverage amounts may vary by state and region. The network must verify coverage with the provider’s professional and general liability insurance carriers. The policy coverage must be current at the time of credentialing.
Malpractice history.
The Network medical director will review all malpractice claims settled against the facility, to determine whether acceptable risk exposure exists. The review is based on information provided, and attested to, by the provider and information available from the carrier.
Accreditation.
For all providers that are accredited, the Network verifies the current accreditation. For those providers that are not accredited but are Medicare-certified, the network verifies the current certification. For those non-accredited providers, a site visit is required. The Network may either perform its own site visit, or defer to the Washington, DC-based Health Care Financing Administration (HCFA) site visit, and obtain a copy of such site visit including any noted deficiencies.
QA/QI program.
OHS will obtain a copy of the provider’s QA/QI program and program evaluation.
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