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RANDOM CASE REVIEW FORM - AAAASF - American Association for ...

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RANDOM CASE REVIEW FORM - AAAASF - American Association for ...

RANDOM CASE REVIEW FORM Period I – January 1 to June 30 Period II – July 1 to December 31 Reviewing Physician: _____ Date: _____

http://www.aaaasf.org/pub/PeerReviewForms.pdf

Date added: November 6, 2011 - Views: 88

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MEDICAL STAFF BYLAWS - Lutheran Health Network

DEFINITION OF PEER: ... review consistent with the hospital’s External Peer Review Policy by a physician who is Board . 2013-02-05 5 certified within the same specialty. 3. Review Form Summary Reviewing physicians must fill out the Peer Review Form, Attachment One, ...

http://www.lutheranhealth.net/med_staff/pdfs/toh/Peer_Review_Policy.pdf

Date added: October 25, 2013 - Views: 1

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General Peer Review Chart Audit Form - Pages - Home

General Peer Review Chart Audit Form Chart # : Clinic : Select Clinic Audit Date : Wednesday, April 05, 2006 Reviewer : Select Reviewer Last Visit Date : Null Clinician : Select Clinician

http://www.cshealthystart.com/Products/Documents/CS%20PIP%20Forms/GeneralPeerReviewChartAudit.pdf

Date added: February 24, 2012 - Views: 213

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Sample Physician Evaluation - Delta Health Care

Sample Physician Evaluation Physician’s name: _____ Specialty: _____ Today’s date: _____ This is a: Self evaluation Peer Evaluation

http://www.deltahealthcare.com/pdf/Sample-Physician-Evaluation.pdf

Date added: June 3, 2012 - Views: 22

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Credentialing Peer Review - Robbins, Salomon & Patt, Ltd ...

ROBBINS, SALOMON & PATT, LTD. Credentialing & Peer Review Ensuring Suitability & Fitness Quality is the key to an effective medical staff.

http://www.rsplaw.com/site/files/909/102733/356947/488695/Group_Practice_Formation_-_Chapter_6.pdf

Date added: October 8, 2013 - Views: 3

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Peer Feedback Form v1 - ABPN

Peer Feedback Form v1. Name of reviewer Hospital Title Address. PERFORMANCE RATINGS . The following guidelines are to be used in selecting the appropriate rating:

http://www.abpn.com/downloads/moc/PIP_peer_feedback_v1.pdf

Date added: March 6, 2012 - Views: 7

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POLICY 19 Physician Peer Review - American College of Medical ...

POLICY 19 Physician Peer Review Peer review is essential to achieving quality of care, promoting patient safety and injecting value into the American

http://www.acmq.org/policies/policies19and20.pdf

Date added: November 10, 2011 - Views: 19

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Peer Review Completion Tool - Nurse Practitioners of Idaho

Page 2 of 2 Peer Review Completion Tool, continued 1. Was there evidence to demonstrate appropriate analysis of the presenting complaint or reason for the

http://www.npidaho.org/documents/peer-review-tool.pdf

Date added: May 30, 2012 - Views: 4

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Physician Peer Review - Oklahoma

I. Peer Review . Peer review provides a mechanism for evaluating the appropriateness of medical and mental healthservices within the Oklahoma Department of Corrections

http://www.ok.gov/doc/documents/op140142.pdf

Date added: August 11, 2013 - Views: 4

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Physician Peer Review Form - ReaderDoc.Com

Physician Peer Review Form form or by any electronic or mechanical means, including information sions, writing workshop share sessions, peer review and

http://www.readerdoc.com/gopdf/physician-peer-review-form.pdf

Date added: June 13, 2014 - Views: 1

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The Peer Review Clinic - Horty Springer

Peer Review Clinic. Topics ... • Should you factor the physician’s peer review history into the ... (Registration form can be found online at www.hortyspringer.com) Fax 412-687-7806 Phone 800-245-1205 Mail HortySpringer Seminars 4614 Fifth Avenue

http://www.hortyspringer.com/wp-content/uploads/2011/09/Peer_Review_Clinic_brochure.pdf

Date added: December 23, 2012 - Views: 6

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Medical Group Employment and Physician Peer Review: Oil and ...

To the contrary, peer review law, and physician peer review itself, are based upon the premise that physicians know best, ... Will the agreement provide an opportunity to the physician for some form of meeting with a medical group committee to discuss the action, and possibly to request

http://www.healthlawyers.org/Events/Programs/Materials/Documents/HHS12/papers/T_schnier.pdf

Date added: August 30, 2014 - Views: 1

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Indicator #20:Indicator #20:Are peer review - SMHConnectionHome

Indicator #20:Are peer review mechanisms in place for you to receive feedback from other mental health staff on the way you handle cases and/or the way you

http://www.schoolmentalhealth.org/Resources/Clin/QAIRsrc/20PeerRvw.pdf

Date added: June 2, 2012 - Views: 6

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Medicare Department of Health and Human Services (DHHS) Peer ...

Medicare Department of Health and Human Services (DHHS) Peer Review Organization Manual HEALTH CARE FINANCING ADMINISTRATION (HCFA) Transmittal 84 Date: DECEMBER 21, 2000

http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R84PRO.PDF

Date added: December 11, 2012 - Views: 2

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Comprehensive Study of Peer Review in California: Final Report

Lumetra: Comprehensive Study of Peer Review in California Final Report iii List of Figures Figure 2.1: Absolute Number of 805 Reports Received by the Medical Board of California by

http://www.mbc.ca.gov/publications/peer_review.pdf

Date added: October 30, 2011 - Views: 20

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PRIVILEGED and CONFIDENTIAL • PEER REVIEW

PRIVILEGED and CONFIDENTIAL • PEER REVIEW . ... this form to gather data for the examinations you submit for accreditation. ... What is the average time from examination to final report being sent to referring physician? 1 Less than 12 hours

http://www.acr.org/~/media/ACR/Documents/Accreditation/CT/Questionnaire.pdf

Date added: April 26, 2013 - Views: 19

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Redefining Peer Review: Current Challenges and Future Directions

Redefining Peer Review: Current Challenges and Future Directions 11 Exhibit A 3 Redefining Peer Review (cont’d)! Contemporary definition: " Evaluation of a physician’s professional performance

http://www.hcpro.com/content/223341.pdf

Date added: May 2, 2013 - Views: 5

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INTRODUCTION - Carrington, Coleman, Sloman & Blumenthal, L.L.P

peer review tality confe These peer onally, their ten years o ade by eve oes not hav ious enough ... Physician Peer Review Immunity: ... is required to form a peer review committee. 66 As opposed to physician peer review, ...

http://www.ccsb.com/pdf/Publications/Health%20Care/Credentialing_and_Peer_Review_of_Healthcare_providers.pdf

Date added: December 18, 2012 - Views: 3

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Best Practices in Hospital Peer Review - AllMed Healthcare

Peer Review Best Practices To ensure an evidence-based outcome for peer reviews, hospitals should consider this nine step process: 1. Develop a culture of accountability within the hospital.

http://www.allmedmd.com/landing-pages/copy_of_bestpracticespeerreview.pdf

Date added: January 10, 2013 - Views: 4

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sample physician peer review letter - Free PDF Downloads Blog ...

physician's peer review file for use in the ... Sample Physician Evaluation - Delta Health Care. ... Sample Proctor Review Form ... The Peer Review Panel consists of ... as a part of the practitioner’s Quarterly review. Comments: The physician was receptive ...

http://www.pdfspath.com/download/sample%20physician%20peer%20review%20letter.pdf

Date added: August 30, 2014 - Views: 1

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YALE NEW HAVEN HOSPITAL DEPARTMENT OF PHYSICIAN SERVICES ...

2 G. Peer review is defined by the process, not by the name that the Department, Section or Hospital applies to the group that

http://www.ynhh.org/vSiteManager/Upload/Images/Professionals/OPPE.pdf

Date added: November 9, 2012 - Views: 2

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OPPE-FPPE Physician Performance Toolkit - NAHQ

OPPE-FPPE Physician Performance Toolkit Contributed by LifePoint Hospitals ... Sample Proctor Review Form—Page 67 Medical Staff Case Review Tool---Page 68 ACCEPTED. ... The Peer Review Panel consists of practitioners assigned

http://www.nahq.org/uploads/apps/files/OPPE-FPPE_Toolkit.pdf

Date added: November 8, 2012 - Views: 21

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PDC PSYCHIATRIC IME / PEER REVIEW Referral Form

PDC PSYCHIATRIC IME / PEER REVIEW Referral Form Fax page to: IME Coordinator (413) 747-9376 Call PDC at (800) 463-0095 with any questions PDC 1350 Main Street – STE 1600, Springfield, MA 01103-1641

http://pdcnetwork.com/images/Psych_website_referral_form_11-15-02.pdf

Date added: March 30, 2012 - Views: 2

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biennial peer review - Nurse Practitioners Idaho | Building ...

Page 1 of 2 Nurse Practitioners of Idaho Peer Review Program Contents 1. Overview of the Program 2. Definition of the Peer Review Process 3. Requirements of the Idaho Board of Nursing

http://www.npidaho.org/documents/peer-review-program.pdf

Date added: September 15, 2012 - Views: 7

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MEDICAL STAFF, CREDENTIALING, AND PEER REVIEW PRACTICE GROUP

Court Orders Peer Review Files Produced in Physician Civil Rights Action Nathan v. The Ohio State University, No. 2:10-cv-872, (S.D. Ohio Oct. 29, 2012)

http://www.healthlawyers.org/Members/PracticeGroups/MSCPR/ExecSumms/Documents/Court_Orders_Peer_Review_Files_Produced_ES.pdf

Date added: August 31, 2013 - Views: 1

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Case Review Request Form - Oregon Health & Science University

Case Review Request Form. To be completed by referring Peer Review Body. If electronic, this form is fillable. After clicking into the 1st field, you may tab your way through the rest.

http://www.ohsu.edu/xd/outreach/oregon-rural-health/hospitals/oregon-rural-healthcare-quality/upload/Case-Review-Request-Form.pdf

Date added: March 23, 2013 - Views: 2

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PEER REVIEW FORM

PEER REVIEW FORM Adjuster: ... Type Of Physician Required: _____ Response Needed By: _____ SPECIFIC QUESTIONS/CONCERNS: ... Review of test results. Physician who performed test: _____ FULL REVIEW OF ...

http://www.fcmfl.com/pdfs/Peer_Review_Form.pdf

Date added: August 31, 2013 - Views: 1

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Radiation Oncology Practice Accreditation Program Requirements

Radiation Oncology Practice Accreditation Program Requirements ... (Census Data Form) from which 10 (or more) will be selected ... Physician peer review activities should be formalized and documented.

http://www.acr.org/~/media/ACR/Documents/Accreditation/RO/Requirements.pdf

Date added: September 28, 2012 - Views: 16

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APN/PA OPPE Chart Review/Peer Review Form Time Frame: August ...

APN/PA OPPE Chart Review/Peer Review Form . Time Frame: August – January _____

http://www.nuhem.com/medicaleducation/Midlevel_Page/Sub%20Folders/Regulatory/APN-PA%20OPPE%20Chart-Peer%20Review%20Form%202012.pdf

Date added: July 7, 2012 - Views: 4

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PEER REVIEW TRAINING - American Physical Therapy Association

Definitions Guidelines: Peer Review Training Claims review: Review of the billing record that may result in identification of issues that may require

http://www.apta.org/uploadedFiles/APTAorg/About_Us/Policies/BOD/Practice/PeerReviewTraining.pdf

Date added: February 18, 2012 - Views: 5

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Medical Staff Peer Review in the Credentialing and ...

Medical Staff Peer Review in the Credentialing and Privileging of Physicians Marvin H. Firestone, MD, JD, ... some form of peer review if hospitals are to be compensated ... from civil liability in connection with the peer review action if the affected physician is given a fair procedure

http://www.ablminc.org/Model_Curriculum_LMME_2010/BOOK_Legal%20Medicine-7th_2007/Ch03-Medical%20Staff%20Peer%20Review_Credentialling&Privileging.pdf

Date added: December 18, 2012 - Views: 3

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ALBANY AREA COMMUNITY SERVICE BOARD Policy and Procedure ...

be audited using the Physician’s Peer Review form (ADM 24). 3. The Medical Director will be responsible for counseling with the newly hired physician when necessary to correct deficiencies or errors in documentation, clinical judgment,

http://www.albanycsb.org/P&P/1800_Physician_Peer_Review_4_6_2011.pdf

Date added: August 31, 2013 - Views: 1

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PDC MEDICAL IME, FCE, PEER REVIEW Referral Form

MEDICAL IME, FCE, PEER REVIEW Referral Form Fax page to: IME Coordinator (413) 747-9376 Call PDC at (800) 463-0095 with any questions ... Internal Medicine Occupational Medicine Physician Neurologist Neurosurgeon

http://pdcnetwork.com/images/Referral_form_Revision_2.pdf

Date added: November 16, 2011 - Views: 6

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Manual: Organizational/Administrative Approved by Board ...

ORG 1005: Medical Staff Peer Review Reviewed/Revised: 02/16/2011 Page 3 of 10 is the obligation of the individual practitioner or committee member to disclose to the

http://www.anaheimregionalmc.com/documents/Med_Staff/MS-1005-ARMC-Peer-Review-P-P-and-Rating-Form.pdf

Date added: May 7, 2013 - Views: 2

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Peer Review Instructions - AAAASF Surveyors

click on “Show” to the right of your physician’s name and click on the temporary Review, ... information must be reported to the Central Office using the Peer Review Exemption form and all ... notify AAAASF by using the Peer Review Exemption Form that can be accessed on-line or you

http://www.aaaasfsurveyors.org/asf_web/PDF%20FILES/PR%20Peer%20Review%20Instructions.pdf

Date added: May 10, 2013 - Views: 8

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Your Medical Center Peer Review Process - WLM Design - Web ...

Your Medical Center Peer Review Process 1. Possible physician quality of care issue identified by : • Quality screen – QI, UR, RM, or Infection control

http://www.wlm-web.com/hcnet/PIFiles/pi019o.pdf

Date added: March 8, 2013 - Views: 3

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Analyzing Credentialing Files: Best Practices

Analyzing credentialing files: Best practices Michael R. Callahan, JD ... Peer review reports Incident reports Patient complaints Quality outcomes Physician-specific Patient Safety Work Product (PSWP)

http://www.kattenlaw.com/files/upload/Presentation_Two.pdf

Date added: February 27, 2014 - Views: 1

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Peer Review - Massachusetts General Hospital Patient Care ...

Peer Review will be based on the 3 domains of the Clinical Recognition Program (see handout) Clinician Patient Relationships Clinical knowledge & Decision Making

http://www.mghpcs.org/pcs/magnet/Documents/PDF/Peer_Review.pdf

Date added: November 16, 2012 - Views: 14

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Peer Review Form 110106 - ACRO

ACRO Peer Review Form Year_____ Quarter_____ Pt Name_____ Pt No._____ Date_____ Performance Measure Satisfactory Yes No Comment 1. Consultation report 2. Histologic Report 3. Site of disease or ICD-9 4. Staging 5. Consent for treatment 6. Treatment Plan 7 ...

http://www.acro.org/media/pdf/standards/Peer%20Review%20Form%20110106.pdf

Date added: April 18, 2012 - Views: 4

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Peer Review Model - Idaho

Peer Review Model 1. Peer Review Process completed annually (quarterly) 2. Form used includes area of yes/no check off and an area for comments

http://ibn.idaho.gov/IBNPortal/IBN/publications/Best%20Practices%20for%20APPNs%20-%20Peer%20Review%20Model.pdf

Date added: April 4, 2012 - Views: 12

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Medical Staff Peer Review Process - Quality Improvement Group ...

Physician and Request Response Service Chief Complete QA Physician Occurrence Report and Return to Medical Staff ... Peer Review Committee Form 07-06b. Title: Medical Staff Peer Review Process Author: BHS Created Date: 7/30/2008 9:54:23 AM ...

http://www.qigconsulting.com/DOCS/23_flowchart_medical_staff_peer_review_process.pdf

Date added: August 29, 2013 - Views: 1

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Credentialing, Recredentialing, and Privileging

Briefings on Credentialing, Credentialing, Peer Review Legal Insider, and Advisor for Medical and ... Sample Peer Review Form ... RESULTS OF PHYSICIAN REVIEW CARE APPROPRIATE - NO FURTHER ACTION NECESSARY ...

http://www.mamss.org/uploads/5/6/9/4/5694386/credentialing_basics_resource.pdf

Date added: April 18, 2012 - Views: 26

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Trauma Center Performance Improvement and Patient Safety Plan

Trauma Peer Review Committee, Trauma Operational Committee, or . ... Trauma PI issues will be documented on the “Trauma Review Form” in Appendix C. ... Trauma Director/Other Physician Review: Signature: ...

http://www.healthy.arkansas.gov/programsServices/injuryPreventionControl/TraumaticSystems/Documents/trauma/Resources/TraumaCenterePIandPSP.pdf

Date added: July 6, 2012 - Views: 14

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Mid-Level Health Practitioner (MHP) Chart Review Name (CNM ...

Mid-Level Health Practitioner (MHP) Chart Review Name (CNM, CRNA, PA, NP ... Supervising/collaborating physician Name: _____ Supervising/collaborating physician Signature ... Confidential: Proceedings, Reports and Records of a Medical Peer Review Committee 1 . Title:

http://www.mercycares.com/uploads/pdf/Quality%20Performance%20Review%20for%20Allied%20Health%20Practitioners%20-%20Form.pdf

Date added: June 17, 2013 - Views: 3

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PATIENTS AND THE PEER REVIEW PROCESS - GSLDS

Association the enclosed Peer Review Request Form along with the Authorization for Release of Confidential Information Form. No action will be taken on your complaint until these forms are returned and signed.

http://www.gslds.org/images/complaintform.pdf

Date added: May 23, 2013 - Views: 1

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REQUEST FOR PEER REVIEW - Alaska

REQUEST FOR PEER REVIEW ... Peer Reviews will not be conducted without a fully completed request form and payment of $50.00 per claim. ... A chiropractic physician involved in a peer review case must submit to the Committee all necessary records and other

http://commerce.alaska.gov/occ/pub/chi4371.pdf

Date added: May 7, 2013 - Views: 1

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07 LeesonIMQ Peer Review 3-11-11 IMQ Short Version

Pay attention to physician feedback on the OPPE reports – Trust? ... Peer review, both internal and external, resulted in suspension of privileges

http://physician-leadership.org/wp-content/uploads/2011/03/07-LeesonIMQ-Peer-Review-3-11-11-IMQ-Short-Version.pdf

Date added: March 11, 2012 - Views: 9

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Texas Board of Nursing Safe Harbor Request to Determine ...

1 Texas Board of Nursing Safe Harbor Request to Determine Medical Reasonableness of a Physician’s Order Published May 2008 Complete this form when you question the medical reasonableness of a physician’s order with regard to

http://www.bon.texas.gov/pdfs/safe_harbor_forms_pdfs/SHPR-MDOrder.pdf

Date added: August 30, 2014 - Views: 1

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Tobacco Use Peer Review Form - Migrant Clinicians Network

RURAL HEALTH CENTER PERFORMANCE DOROVENŒNT PROGRAM S 5 N/A PHYSICIAN PEER REVŒW TOBACCO USE Patient Name. Date ofLast Visit Pri Care Provider.

http://www.migrantclinician.org/files/resourcebox/TobaccoUsePeerReviewForm.pdf

Date added: August 30, 2014 - Views: 1

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Critical Components of A Quality Program: Including Ongoing ...

Critical Components of A Quality Program: Including ... Mid-Level Peer Review Supervising physician must periodically review Mid-Level records and complete a peer review form indicating: Medical assessment and diagnosis appropriate

http://neahq.org/Attachments/Critical%20Components%20of%20Quality%20Program%20Including%20OPPE%20%20COLOR%2002%2005%2010.pdf

Date added: September 25, 2012 - Views: 10