Proper Credentialing of Physicians May Reduce Hospital Liability

Case studies, like one shared in a recent newsletter from insurance broker Willis Towers Watson, demonstrate the need for hospitals and other healthcare facilities to establish and follow sound credentialing practices.

In the lawsuit described, the plaintiff won a $7 million verdict against the hospital for what is called “negligent credentialing.” According to Willis Towers Watson, this means the plaintiff demonstrated not only that the physician acted negligently but also that the hospital’s failure “to meet its duty of due care to perform the credentialing process … was a proximate cause of the resulting injuries.”

To reduce the potential liability related to negligent credentialing, Willis Towers Watson recommends that hospitals:

• review the credentialing process periodically for compliance and loss prevention opportunities;
• share lessons learned with the medical staff office and chief medical officer on claim and loss trends;
• review bylaws and code of ethics; and
• support timely and effective peer review.

MLMIC encourages all hospitals and healthcare facilities to ensure both rigorous credentialing and thorough follow-through of all steps in the process. We are always here to answer your questions and assist with your risk management efforts. Please call (212) 576-9601 with specific concerns or questions.