Your Federal Quarterly Tax Payments are due April 15th Get Help Now >>

Employee Application Letter Example by lgx19920

VIEWS: 476 PAGES: 5

Employee Application Letter Example document sample

More Info
									      PROCESS OUTLINE FOR CREDENTIALING/PRIVILEGING                         Your participation and feedback are vital to the success of these tools. If you have questions, suggestions or updates
            PROSPECTIVE CLINICAL SALARIED FACULTY                                     regarding this outline, please contact Jane Barth at jbarth@email.arizona.edu or at 520-626-4368.
ALERT: As of Feb 1, procedure for UPH-K privileging may be changed. Consult Peggy Goforth at 694-5111 before proceeding .
       To be used in conjunction with the Process Outlines for Salaried Faculty                    *** Red asterisks indicate variation in process by faculty type.                   Tasks are listed in approximate
       Hiring/Appointmts and Title Approvals, and with the Combined Checklist.                   Please refer to the "Relevant Contacts" list for contact information.                order; additional notes re order
Task                                                                                       Explanation / Attachments to Primary Task Object, in order /           Receiver or         and deadlines are below, when
 #                   Task                   Initiating Role      Primary Task Object           ***Variation by Faculty Type / Contact for Questions             Distribution List                available.
       DEPT notifies DEPT
       COORDINATOR that                                                                                                                                                    Credentialing/privileging process
       CANDIDATE identified as                                                                                                                                             must be initiated ASAP for all
       needing UPH credentialing                              DEPT HEAD, SECTION                                                                                           clinical faculty who will be UPH
       (from now on, "NEW UPH                                 CHIEF, SEARCH                                                                                    DEPT        members or employees (part-time
1      MEMBER OR EMPLOYEE."                                   COMMITTEE CHAIR, etc.                                                                            COORDINATOR contractors).

       DEPT instructs NEW UPH                         Paper app or link to AZ Med       If NEW UPH MEMBER OR EMPLOYEE already has AZ medical
       MEMBER OR EMPLOYEE to               DEPT       Board:                           license, make sure it will be active by hire date and if any address    NEW UPH              Good to do early if needs to apply
       submit application for AZ           COORDINATO http://www.azmd.gov/license/     information needs to be updated. ***Medical licenses required of        MEMBER OR            for AZ license, as can take 6
2      Medical License.                    R          Application_MD_license.pdf       MDs and DOs only; get appropriate counterpart from PhDs.                EMPLOYEE             months.
       DEPT instructs NEW UPH
       MEMBER OR EMPLOYEE to               DEPT       Link to DEA                                                                                              NEW UPH
       initiate DEA license or transfer    COORDINATO Website:http://www.deadiver                                                                              MEMBER OR            Cannot be done until AZ medical
3      current DEA to AZ.                  R          sion.usdoj.gov/                                                                                          EMPLOYEE             license has been issued.
                                                                                                                                                                                    Need NPPDF ASAP to initiate
       DEPT fills out UPH NPPDF as                                                     UPH requires that CV shows months and years for education and                                credentialing. Some depts get
       much as possible and sends to                                                   employment history and UPH as current employer (starting expected                            missing information from
       NEW UPH MEMBER OR             DEPT       UPH NPPDF (New                         hire date). This can be done by mail, fax, email--or just by calling the NEW UPH             candidate at interview stage--if
       EMPLOYEE to complete and      COORDINATO Physician/Provider Data                candidate, asking for the missing info and revising the CV with          MEMBER OR           fairly certain they will be offered
4      return with UPH-required CV.  R          Form)                                  his/her approval.                                                        EMPLOYEE            the job.
       DEPT sends completed                                                                                                                                    San Harrison,
       NPPDF & UPH-required CV to                                                      This initiates the credentialing process, which usually takes 4-6       UPH CMOO             If EXTREME rush, can send
       UPH, when received from    DEPT                                                 months. See linked Flowchart of UPH Credentialing Process and           @UMC Room            NPPDF for now with regular CV
       NEW UPH MEMBER OR          COORDINATO UPH Emp & Credentialing                   UPH Employment & Credentialing Process linked at left for complete      #2302a, P O Box      and send UPH CV along when
5      EMPLOYEE.                  R          Process 2007                              explanation of UPH process.                                             245005               available--ASAP.


                                                                                       Do if UPH NPPDF indicates that UMC privileges are required. Dept        Nora Alabado @
       DEPT fills out and routes or                                                    can arrange with Nora Alabado to pick up application for Candidate      UMC Chief of
       delivers UMC APPL Request        DEPT                                           when ready (and mail with the UPH application) or for her to mail       Staff's Office
       Form to Nora Alabado to initiate COORDINATO                                     directly to and receive directly from Candidate. She prefers to deal    Room #2438, fax Do at same time or immediately
6      UMC privileging, if needed.      R          UMC APPL Request Form               directly with the candidate herself.                                    694-6130        after sending NPPDF to UPH.
       DEPT requests other                 DEPT                                                                                                                e.g., TMC, NW
       cred/privileging applications, if   COORDINATO                                  From other hospitals where faculty will admit patients or from          Hospital, St.
7      appropriate.                        R                                           insurance payers who don't delegate credentialing to UPH.               Mary's, etc.
       DEPT begins UPH
       Credentialing Checklist, sends                                                                                                                          San Harrison,        San Harrison prefers to receive
       original to San with first item(s)                                                                                                                      UPH CMOO             checklist with first item(s) on it that
       available (other than NPPDF & DEPT                                              DEPT COORDINATOR and San Harrison will use checklist to                 @UMC Room            become available (beyond NPPDF
       CV), then sends others as          COORDINATO UPH New Provider                  monitor progress. See linked Clarifications re Items on Checklist.      #2302a, P O Box      & CV). She and Dept then each
8      available.                         R          Credentialing Checklist           San Harrison, UPH CMOO Asst II, 694-5111, sharrison@uph.org             245004               maintain their own.


                                                                                                                                           3ea6cc80-9700-411c-93e4-543c601b962f.xls, 3/04/08, p. 1 of 5
      PROCESS OUTLINE FOR CREDENTIALING/PRIVILEGING                         Your participation and feedback are vital to the success of these tools. If you have questions, suggestions or updates
            PROSPECTIVE CLINICAL SALARIED FACULTY                                     regarding this outline, please contact Jane Barth at jbarth@email.arizona.edu or at 520-626-4368.
ALERT: As of Feb 1, procedure for UPH-K privileging may be changed. Consult Peggy Goforth at 694-5111 before proceeding .
       To be used in conjunction with the Process Outlines for Salaried Faculty                    *** Red asterisks indicate variation in process by faculty type.                  Tasks are listed in approximate
       Hiring/Appointmts and Title Approvals, and with the Combined Checklist.                   Please refer to the "Relevant Contacts" list for contact information.               order; additional notes re order
Task                                                                                       Explanation / Attachments to Primary Task Object, in order /           Receiver or        and deadlines are below, when
 #                   Task                Initiating Role       Primary Task Object             ***Variation by Faculty Type / Contact for Questions             Distribution List               available.
                                                                                                                                                               San Harrison,
       When notified of its arrival,                                                                                                                           UPH CMOO
       DEPT picks up UPH                DEPT                                                                                                                   @UMC Room       San Harrison phones or emails
       Credentialing Application        COORDINATO UPH Credentialing                   Please refer to the Guidelines re UPH Cred App Packet Before            #2302a, P O Box when ready - usually about 1 week
9      Packet from UPH CMOO.            R          Application Packet                  Sending.                                                                245004          after NPPDF & CV submitted.
       If Dept mailing UMC
       application, pick up from Nora
       when notified it's ready and     UMC Chf of                                     If Dept arranged with Nora Alabado to follow up on UMC privileging NEW UPH
       send to New UPH Member or        Staff Office to                                application, do so. Normally, Nora Alabado will communicate directly MEMBER OR               May be sent with UPH application
10     Employee.                        DEPT COORD                                     with the candidate herself about this.                               EMPLOYEE                packet or separately.

       DEPT sends UPH
       Credentialing Application                                                       Do ASAP! UPH Credentialing Application Packet in exact order
       Packet to NEW UPH MEMBER DEPT          UPH Credentialing                        received, with tabs. Recommended to FedEx to NEW UPH                    NEW UPH              Give NEW UPH MEMBER OR
       OR EMPLOYEE with            COORDINATO Application Packet Cover                 MEMBER OR EMPLOYEE to reinforce need for quick                          MEMBER OR            EMPLOYEE at least a week to
11     explanatory memo or letter. R          Memo (Example)                           turnaround.                                                             EMPLOYEE             complete.
                                                                                                                                                                                    Copy of Social Security card
       DEPT requests copy of Social DEPT                                                                                                                       NEW UPH              needed by UPH CMOOistration
       Security card from NEW UPH COORDINATO                                                                                                                   MEMBER OR            (San Harrison) by start date--
12     MEMBER OR EMPLOYEE           R                                                  Needed by UPH CMOO for payroll purposes.                                EMPLOYEE             earlier if possible.
       DEPT sends other
       Credentialing / Privileging Apps DEPT                                                                                                                   NEW UPH
       as needed w/UPH apps or          COORDINATO other cred/privileging              If NEW UPH MEMBER OR EMPLOYEE needs credentialing or priv               MEMBER OR
13     separately                       R          applications as needed              with any non-UPH-delegating payors or hospitals                         EMPLOYEE

                                                                                       *** or, if faculty will be less than .50 FTE, Contract for Professional                      This document can be drafted and
       DEPT sends draft UPH             DEPT       UPH Member Practice                 Services, which must indicate a per-hour wage subject to approval by San Harrison,           sent to UPH as early as with
       contract w/estimated start       COORDINATO Agreement for full-time             Terre LeBaron once sent to UPH. Either version is referred to by        sharrison@uph.o      NPPDF form, or later in the
14     date to UPH ***.                 R          faculty (.50 and above)***          UPH as the "UPH Contract." Type "DRAFT" at top                          rg                   process.
       NEW UPH MEMBER OR
       EMPLOYEE returns & Dept
       receives completed UPH           NEW UPH            Completed UPH
       Credentialing Application        MEMBER OR          Credentialing Application                                                                           DEPT
15     Packet                           EMPLOYEE           Packet                                                                                              COORDINATOR
                                                                                                                                                                                    Credentials verification can take
                                                                                                                                                                                    up to six months; chances for
       DEPT reviews completed UPH                                                      This is time-consuming if done thoroughly, but it will really help                           shorter processing will be
       Credentialing Application        DEPT       Completed UPH                       minimize delays in the Credentialing/Privileging process. Please                             increased by submission of
       Packet & requests missing        COORDINATO Credentialing Application           consult the Guidelines for Reviewing Completed Credentialing /          NEW MEMBER           COMPLETE applications, with all
16     items if necessary.              R          Packet                              Privileging Application Packets.                                        OR HIRE              supporting materials.




                                                                                                                                           3ea6cc80-9700-411c-93e4-543c601b962f.xls, 3/04/08, p. 2 of 5
      PROCESS OUTLINE FOR CREDENTIALING/PRIVILEGING                         Your participation and feedback are vital to the success of these tools. If you have questions, suggestions or updates
            PROSPECTIVE CLINICAL SALARIED FACULTY                                     regarding this outline, please contact Jane Barth at jbarth@email.arizona.edu or at 520-626-4368.
ALERT: As of Feb 1, procedure for UPH-K privileging may be changed. Consult Peggy Goforth at 694-5111 before proceeding .
       To be used in conjunction with the Process Outlines for Salaried Faculty                  *** Red asterisks indicate variation in process by faculty type.                  Tasks are listed in approximate
       Hiring/Appointmts and Title Approvals, and with the Combined Checklist.                 Please refer to the "Relevant Contacts" list for contact information.               order; additional notes re order
Task                                                                                     Explanation / Attachments to Primary Task Object, in order /           Receiver or        and deadlines are below, when
 #                    Task                Initiating Role      Primary Task Object           ***Variation by Faculty Type / Contact for Questions             Distribution List               available.


       DEPT makes copies of health                                                                                                                           UPH
       screening forms from packet,      DEPT                                                                                                                EMPLOYEE
       and routes separately to UPH      COORDINATO copies of TB skin tests and                                                                              HEALTH via
17     Employee Health.                  R          vaccination records                                                                                      UPH Courier
                                                                                     Application only valid for 6 months, so take to UPH ASAP. Dept
       DEPT delivers completed           DEPT       Completed UPH                    advised to make copy of packet for own files except for Health
       UPH Credentialing                 COORDINATO Credentialing Application        Screening forms, which should not be kept in dept. When received,       San Harrison,
18     Application Packet to UPH.        R          Packet                           CMOO will forward to CVO, etc.                                          UPH CMOO
       UPH CMOO routes completed
       application to Credentialing
       Verification Organization
19     (CVO).                            UPH CMOO
                                                                                                                                                             NON-
                                                                                                                                                             DELEGATING
       DEPT follows up on other                                                                                                                              PAYORS,
       completed Cred/Priv                                                                                                                                   Tucson
       applications when received        DEPT                                                                                                                hospital(s) other
       from NEW UPH MEMBER OR            COORDINATO                                                                                                          than UPHK or
20     EMPLOYEE, if applicable.          R                                                                                                                   UMC.


                                                            Finalized UPH New Member
                                         San Harrison,      Practice Agreement or
       UPH CMOO sends UPH                UPH CMOO           Contract for Professional
       contract ( 2 orig.) to dept for   ASST II, UPH       Services for less than .50                                                                       DEPT        Usually happens within a week of
21     signatures ***                    CMOO@UMC           FTE, drafted earlier       San Harrison & UPH CMOO                                               COORDINATOR UPH receiving draft from DEPT.
                                                                                                                                                          San Harrison,
       DEPT continues to follow up                                                                                                                        UPH CMOO
       with items on UPH                                                                                                                                  @UMC Room
       Credentialing Checklist and       DEPT                                        San Harrison will send out reminders about anything she doesn't yet #2302a, P O Box
       advises UPH of any changes        COORDINATO                                  have one month before expected hire date. Refer to Clarifications if 245004; 694-
22     to expected start date.           R                                           questions re items.                                                  5112
                                                                                                                                                                                  Credentials verification can take
       If rush to credential, DEPT                                                                                                                                                up to six months; chances for
       contacts UPH CMOO to see if                                                                                                                                                shorter processing will be
       anything to do to facilitate      DEPT                                                                                                                                     increased by submission of
       credentialing verification        COORDINATO                                                                                                                               COMPLETE applications, with all
23     process.                          R                                           Peggy Goforth, Mgr, UPH Admin Serv, pgoforth@uph.org                                         supporting materials.




                                                                                                                                         3ea6cc80-9700-411c-93e4-543c601b962f.xls, 3/04/08, p. 3 of 5
      PROCESS OUTLINE FOR CREDENTIALING/PRIVILEGING                         Your participation and feedback are vital to the success of these tools. If you have questions, suggestions or updates
            PROSPECTIVE CLINICAL SALARIED FACULTY                                     regarding this outline, please contact Jane Barth at jbarth@email.arizona.edu or at 520-626-4368.
ALERT: As of Feb 1, procedure for UPH-K privileging may be changed. Consult Peggy Goforth at 694-5111 before proceeding .
       To be used in conjunction with the Process Outlines for Salaried Faculty                          *** Red asterisks indicate variation in process by faculty type.                  Tasks are listed in approximate
       Hiring/Appointmts and Title Approvals, and with the Combined Checklist.                         Please refer to the "Relevant Contacts" list for contact information.               order; additional notes re order
Task                                                                                             Explanation / Attachments to Primary Task Object, in order /           Receiver or        and deadlines are below, when
 #                   Task                    Initiating Role       Primary Task Object               ***Variation by Faculty Type / Contact for Questions             Distribution List               available.

                                                                                                                                                        DEPT HEAD,
                                                                                                                                                        NEW UPH                           Templates linked above when first
                                                                                                                                                        MEMBER OR                         drafted; signing can be done
                                            DEPT       Finalized UPH New Member                                                                         EMPLOYEE,                         earlier or later than this--though
       Cand. & Dept Head Sign UPH           COORDINATO Practice Agreement (.50 FTE *** or Contract for Professional Services if < .50 FTE). UPH New San back to DEPT                      contract must be redrafted if hire
24     contract - 2 orig.***                R          or more)                    Harrison, UPH CMOO Asst II, 694-5113                                 COORDINATOR                       date changes.
       DEPT sends 2 signed UPH              DEPT                                *** or, if faculty will be less than .50 FTE, the Contract for                       UPH
       contracts to UPH CMOO for            COORDINATO Signed Finalized UPH New Professional Services. Start date must be accurate. UPH New San                      CMOO@UMC             Necessary for COM appointment
25     UPH CEO signature.                   R          Member PracticeAgreement Harrison, UPH CMOO Asst II, 694-5114                                                 Room #2302a          to be approved beforehand?
                                                                                                                                                              Peggy Goforth,
       If UPH CMOO notifies DEPT it                                                                                                                           Mgr, UPH
       is impossible to get                                                                  If necessary, DEPT may request Temp Cred from Peggy Goforth, in CMOO.
       credentialing completed by Hire      DEPT                                             which case "Clean files" can be expedited for UPH Temp Cred by   Services, 694-
       Date, DEPT may request Temp          COORDINATO                                       having CMO sign--but should be aware not honored by some payors. 5111 or 874-
26     Cred.                                R                                                Temp Privs not allowable for UMC.                                7310.
       Credentialing Process                                                                 If all Credentialing Checklist documents received by CMOO, file is                           UPH Credentialing Committee
       Finalized or Temp Cred                                                                taken to next UPH Credentialing Committee meeting for final review                           meetings are held 1st Wed of
27     Granted                              UPH CMOO                                         & approval.                                                                                  each month.


       PRIV REP (Nora Alabado for           Nora Alabado
       UMC) delivers Delineation of         (UMC - 694-                                                                                                               CLINICAL DEPT
       Privileges Form, if applicable, to   4943) or ??                                      Complete credentialing file goes to clinical head for review but not for HEAD OR
       Dept. Clinical Head for Sig. with    (UPHK - 874-       Hospital Privileging          copying--highly confidential. How does this happen for UPHK and          SECTION
28     verified credentialing file.         7311)              Delineation Form              others?                                                                  CHIEF

                                                                                                                                                                     UMC CRED
                                                                                                                                                                     COORDINATOR
                                                                                                                                                                     (UMC 2438 or
                                                                                                                                                                     694-6130) and/or
                                                                                                                                                                     UPHK
                                                                                                                                                                     PRIVILEGING
                                                                                                                                                                     COORD (c/o
                                                                                                                                                                     San Harrison
       CLINICAL DEPT HEAD (or               CLINICAL                                                                                                                 UPH
       other authority) signs and           DEPT HEAD          completed Delineation of                                                                              CMOO@UMC
       returns Delineation of               OR SECTION         Hospital Privileges Form(s)                                                                           Room #2302a,
29     Hospital Privileges Form.            CHIEF, etc.        signed by Dept Head                                                                                   fax 874-3425)




                                                                                                                                                 3ea6cc80-9700-411c-93e4-543c601b962f.xls, 3/04/08, p. 4 of 5
      PROCESS OUTLINE FOR CREDENTIALING/PRIVILEGING                         Your participation and feedback are vital to the success of these tools. If you have questions, suggestions or updates
            PROSPECTIVE CLINICAL SALARIED FACULTY                                     regarding this outline, please contact Jane Barth at jbarth@email.arizona.edu or at 520-626-4368.
ALERT: As of Feb 1, procedure for UPH-K privileging may be changed. Consult Peggy Goforth at 694-5111 before proceeding .
       To be used in conjunction with the Process Outlines for Salaried Faculty                *** Red asterisks indicate variation in process by faculty type.                  Tasks are listed in approximate
       Hiring/Appointmts and Title Approvals, and with the Combined Checklist.               Please refer to the "Relevant Contacts" list for contact information.               order; additional notes re order
Task                                                                                   Explanation / Attachments to Primary Task Object, in order /           Receiver or        and deadlines are below, when
 #                   Task                  Initiating Role   Primary Task Object           ***Variation by Faculty Type / Contact for Questions             Distribution List               available.



       DEPT makes sure NEW UPH
       MEMBER or EMPLOYEE gets                                                                                                                                                  NEW UPH EMPLOYEE
       online compliance packet                                                                                                                                                 (PHYSICANS contracted < .50
       from UPH CMOO and                                                                                                                                                        FTE, NOT MEMBERS) needs to
       completes ASAP--and, for           DEPT                                                                                                                                  do I-9 form within 3 days of hire
       NON-MEMBERS only--goes to          COORDINATO                                                                                                                            date, preferably before.
       CMOO to do I-9 Form (only          R, NEW UPH                               NEW UPH MEMBER OR EMPLOYEE must submit copy of SS card UPH                                   EMPLOYEES and MEMBERS
       physicians contracted at < .50     MEMBER OR                                no matter what ID is used for I-9, for payroll purposes. UPHK should CMOO@UMC                must complete on-line Compliance
30     FTE, not MEMBERS).                 EMPLOYEE                                 be scheduling UPHK orientation.                                      Room #2302a             Packet before can see patients.

       DEPT receives UPH contract
       signed by UPH CEO from             UPH CMOO /
       UPH CMOO, keeps copy,              DEPT                                                                                                              NEW UPH
       gives original to NEW UPH          COORDINATO                                                                                                        MEMBER OR
31     MEMBER OR EMPLOYEE.                R                                                                                                                 EMPLOYEE


       NEW UPH MEMBER OR
       EMPLOYEE meets with UA
       benefits representative if clinical NEW UPH                                 Clinical faculty usually select UPH insurance/medical benefits but
       UPH member, completes UA            MEMBER OR                               have a choice between UPH and UA, so AHSC HR rep meets with                                  NEW UPH MEMBER OR
32     benefits enrollment***.             EMPLOYEE                                them to explain: 626-2600                                                AHSC-HR             EMPLOYEE gets UA Net ID
       NEW UPH MEMBER OR
       EMPLOYEE meets with UPH            NEW UPH
       benefits representative,           MEMBER OR                                UPH benefits start the first day of the month following the hire date.   UPH Benefits
33     completes enrollment..             EMPLOYEE                                 So if hire date is 7/1 or 7/30, benefits begin on 8/1.                   874-7281
       UPHK Orientation (***for                                                                                                                       NEW UPH
       hospitalists with UPHK                                                                                                                         MEMBER OR  Necessary before NEW UPH
       privileges); gets parking permit   UPHK Medical                              ***Scheduled by Lynn Bonamy in the Medical Staff Office of UPHK - EMPLOYEE / MEMBER OR EMPLOYEE can
34     for UPHK                           Staff Office                             874-3372, fbonamy@uph.org; Should be done before faculty starts. NEW FACULTY see patients?
       NEW UPH MEMBER OR
       EMPLOYEE / New Faculty                                                                                                                               NEW UPH
       advised of and attends UMC                                                                                                                           MEMBER OR
       Orientation (***if will practice at UMC Chf of                                                                                                       EMPLOYEE /
35     UMC)                                Staff                                                                                                            NEW FACULTY




                                                                                                                                       3ea6cc80-9700-411c-93e4-543c601b962f.xls, 3/04/08, p. 5 of 5

								
To top