Medical Staff Office
The Anderson Hospital Medical Staff Office is here to assist in simplifying the healthcare practitioner’s experience related to application and primary source verifications. Healthcare practitioners can conveniently access credentialing documents by clicking on the links below or emailing the Medical Staff Office directly.
Meet the Medical Staff Office
618.391.6104
618.391.6140
618.391.6142
618.391.6141

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.
Forms
Initial Credentialing Documents:
- Anderson Healthcare Application Letter
- State of Illinois Credentialing Application
- Anderson Healthcare Entity Application
- Anderson Healthcare Attestation
- Anderson Healthcare Consent to Release
- Anderson Healthcare Background Check Authorization Form
- Anderson Healthcare CME Attestation
- Anderson Healthcare Provider Contact Form
- Anderson Healthcare Supplement Information Form
- Anderson Healthcare Conflict Disclosure Statement
- Anderson Healthcare Provider Signature Form
- Anderson Healthcare Code of Excellence and Code of Conduct
- Anderson Healthcare Expectations of Practitioners
- Anderson Healthcare Physician Acknowledgement Statement
- Anderson Healthcare Confidentiality Agreement
- Anderson Healthcare Covering Provider Form
- Anderson Healthcare Application Fee Invoice
- Anderson Healthcare Peer Recommendation Form
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
- Dates
- Issue Number
- Volume
- Page Number(s)
