Meet the Medical Staff Office
Medical Staff Office Services
Our Medical Staff Office performs the following services for Anderson Hospital:
- Initiate the application process by providing credentialing application packets and hospital criteria to applying practitioners.
- Collect and process applications for initial appointment and reappointment.
- Process status change requests and additional privilege requests.
- Obtain primary source verifications by verifying all elements of the application directly with the sources, such as medical school, training programs, hospital affiliations, licensures, peer references, etc.
- Maintain credentialing database.
- Assist in preparation and participate in the credentialing verification portion of accreditation and regulatory surveys.
- Coordinate, organize, and attend meetings of the medical staff.
- Prepare and distribute call schedules.
Initial Credentialing Documents:
- Welcome Letter and Checklist
- State of Illinois Healthcare Professional Credentialing and Business Data Gathering Form
- Application Fee Invoice
- Supplemental Information Form
- Medical Staff Status Description
- Consent and Release Form
- Health Statement
- Background Check Authorization Form
- Provider Contact Form
- Provider Signature Card
- Conflict Disclosure Statement
- Statement of Authorization & Release
- Notice to Physicians Acknowledgement
- Autofaxing Enrollment
- CME Form
- 3-Peer Reference Forms
- Code of Conduct
Call Schedules, Requests for Clinical Activity, and Library Requests
Call schedules and requests for clinical activity may be submitted by emailing the Medical Staff Office. Clinical activity logs will cover the past 24 months unless otherwise requested.
While we don’t have the capability to conduct research, our staff is happy to assist you with requests for specific articles. Requests for articles may be submitted via email to the Medical Staff Office. When applicable, requests should include the following:
- Journal Name
- Article Name
- Issue Number
- Page Number(s)