INTRODUCTION

Thank you for your interest in

providing medical care and treatment to
our Health Plan members. The provision
of care requires that you undergo a
thorough credentialing verification
process and be approved to participate in
treating our members. If your
employment requires that you provide
inpatient care you will need to apply for CREDENTIALING,
Professional Staff Membership and
hospital privileges, as well. HOSPITAL
Time frames for processing an
application vary depending upon how PRIVILEGING
quickly our requests for information are
acted upon. If we have been unsuccessful
at obtaining certain verifications, you AND PROCTORING
may be asked to intercede or to supply
additional information to support your
application packet.
Our Organization is committed to
improving and maintaining the health of
our members. To ensure quality ∝ Credentialing
∝ Privileging Process
throughout the continuum we have
adopted the guidelines of the National
Committee for Quality Assurance
(NCQA) and the Joint Commission on
∝ Proctoring and
Accreditation of Healthcare Current Competency
Organizations (JCAHO). We also follow
the guidelines of the Medical Directors
Quality Review (MDQR), which is an
internal compliance body.
We look forward to working with you on
a collaborative basis in order to achieve
the timely processing of your application.
Rev. 01-04
 INITIAL CREDENTIALING
The credentialing process includes a
thorough verification of your professional
history. To initiate the application process,
you must provide the following:
• A complete application
• Curriculum Vitae
• Professional Education and Training
(Including ECFMG if applicable)
• Medical License(s)
• DEA Certificate
• Certification
• Adequacy of Professional Liability
Insurance and Claims History (For the
previous 10 years, including
explanation of any claims made)
• Work History (including past and
present hospital affiliations)
• National Practitioner Databank
• Regulatory Actions and/or Sanctions
• Three letters of professional reference
The Medical Staff Office must verify the
accuracy of the application through
primary source verification. Upon
completion of the verification process,
members of the Credentials and Privileges
Committee will review your application
and may approve you to participate in the
treatment of Health Plan members. The
credentialing process is program wide
and allows you to provide care in the
ambulatory setting throughout the Kaiser
Permanente Medical Care Program,
Northern California.
HOSPITAL PRIVILEGING
If you are to provide medical care and
treatment to our Health Plan members in
the inpatient setting, you must apply for
hospital privileges and appointment to
the Professional Staff to Kaiser
Foundation Hospital. Your initial
application will serve as the basis for the
credentialing and the privileging
process.
Professional Staff membership and
privileges are hospital specific and are
not transferable to other Kaiser Hospital
facilities. You must apply at each
Kaiser Foundation Hospital where
you need to provide inpatient care.
Your application and privilege request
will be acted upon at the local level by
the Credentials and Privileges and
Medical Executive Committees prior to
review by the Kaiser Foundation
Hospital Board of Directors (BOD).
The BOD is the governing body with
full and final authority to grant
professional staff membership and
hospital privileges.
PROCTORING PROGRAM
Upon approval of the Kaiser
Foundation Hospital Board of
Directors, you will be appointed to
the Professional Staff.. To ensure
patient safety and quality of care, and
as a means of evaluating your current
competency in the privileges you
have requested and have been
granted, you will be proctored. The
proctoring period will not exceed the
timeframe as specified in the hospital
bylaws. You may not perform the
procedures you have requested
without a proctor until you have
successfully satisfied the established
facility and department-specific
proctoring policies and criteria.
The Medical Staff Office will also
verify “current competency” by
contacting your training program(s)
as well as your current and past
hospital affiliations.
Proctoring policies and criteria are
hospital-specific. You will be
proctored at each facility where you
provide inpatient care.