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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

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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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/PHY12/papers/J_schnier.pdf

Date added: December 18, 2012 - Views: 3

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

Credentialing & Peer Review ... It starts with the credentialing process upon initial hire, and continues throughout a physician's tenure with the group practice thru periodic performance evaluations, peer review and recredentialing.

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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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 1 of 2 Nurse Practitioners of Idaho Peer Review Completion Tool Instructions: This review tool is offered by NPI for use to document the peer review analysis of NP care

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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Best Practices in Hospital Peer Review - AllMed Healthcare

Best Practices In Hospital Peer Review Why Peer Review Isn’t Working When done properly, peer review is an important process that helps hospitals

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

Date added: January 10, 2013 - Views: 4

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Comprehensive Study of Peer Review in California: Final Report

Peer Review Body Final Report Form to the Physician Diversion Program Regarding an Investigation of a Mentally or Physically Disabled Physician ... physician, the peer review process is a significant part of the investigation and any discipline that

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

Date added: October 30, 2011 - Views: 20

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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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Initial Physician Review Form CONFIDENTIAL PEER REVIEW

Case ID # Initial Physician Review Form CONFIDENTIAL PEER REVIEW RN Screener: Pursuant to Idaho Code 39­1392 MR #: D/C Date: Referral Date: Date Submitted For Review:

http://www.stlukesonline.org/for_physicians/committees/documents/MicrosoftWord-rptPeerReviewTrackingFormPrePhysReview.pdf

Date added: October 8, 2013 - Views: 9

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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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The Peer Review Clinic - Horty Springer

The Advanced Roundtable for Physician Leaders The Peer Review Clinic For reservations, please call 415-296-7465. Room Rate: $419 ... (Registration form can be found online at www.hortyspringer.com) Fax 412-687-7806 Phone 800-245-1205 Mail HortySpringer Seminars

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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PRIVILEGED and CONFIDENTIAL • PEER REVIEW

PRIVILEGED and CONFIDENTIAL • PEER REVIEW . ... this form to gather data for the examinations you submit for accreditation. ... When patients are being imaged, how often is a physician on site? 1 100-95% of the time . 2 94-75% 3 74-50%

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

Date added: April 26, 2013 - Views: 19

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

privileges, but committee recommendations form the basis upon which the hospital’s governing body makes its decision.4 At both stages, ... Unlike most physician peer review statutes, the nursing peer review statute also provides

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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OPPE-FPPE Physician Performance Toolkit - NAHQ

Sample Proctor Review Form—Page 67 Medical Staff Case Review Tool---Page 68 ACCEPTED. ... equal qualifications as the individual under review (for example, physician and physician, dentist and dentist, etc). b. Responsibility- ... 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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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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Nurse Practitioners of Idaho

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 Peer Review in the Credentialing and ...

Chapter 3 Medical Staff Peer Review in the Credentialing and Privileging of Physicians Marvin H. Firestone, MD, JD, FCLM Medical Staff Peer Review

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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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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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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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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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, ... the court found that performance issues could form the basis of either employment action or hospital peer review action. Specifically, Harter

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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Radiation Oncology Practice Accreditation Program Requirements

Individual physician/physicist peer review Patient satisfaction surveys New patient conferences Port film/image review ... Documentation of delivered doses to volumes of target and non-target tissues, in the form of

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

Date added: September 28, 2012 - Views: 16

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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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Manual: Organizational/Administrative Approved by Board ...

peer review activities. Physician reviewers will be assigned alphabetically within the ... All cases undergoing peer review will have a Peer Review Form work sheet completed, which captures the rationale for the conclusion made by the peer reviewer(s).

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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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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Analyzing Credentialing Files: Best Practices

some other form of review or remedial action? ... Peer review reports ... physician complaints, concern is that disclosure of records could lead to retaliation by physician and subsequent reduction of reporting. Physician access to credentials files

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

Date added: February 27, 2014 - Views: 1

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PDC MEDICAL IME, FCE, PEER REVIEW Referral Form

PDC MEDICAL IME, FCE, 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/Referral_form_Revision_2.pdf

Date added: November 16, 2011 - Views: 6

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Credentialing, Recredentialing, and Privileging

Sample Peer Review Form ... RESULTS OF PHYSICIAN REVIEW CARE APPROPRIATE - NO FURTHER ACTION NECESSARY - Please provide documentation to reflect the bases for decision regarding the appropriateness of review of care/service.

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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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 Instructions - AAAASF Surveyors

Page 1 of 2 Peer Review Instructions Prior to Peer Review Data Entry You Will Need: Six completed Random Review Forms for each surgeon in your facility and all completed Unanticipated

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

Date added: May 10, 2013 - Views: 8

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2009 Physician Peer Review Manual - Welcome to HealthInsight.org

2009 Physician Peer Review Manual . New Mexico Medical Review Association NMMRA Medicare Peer Review Manual(Revised April 2009) Page ii . NMMRA's mission is to facilitate demonstrable and . ... 2.5 Peer Review Assessment Form and Samples ...

http://www.nmmra.org/resources/Review/150_1762.pdf

Date added: May 7, 2013 - Views: 5

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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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Proposal for External Peer Review - Maryland

blinded cross-institutional physician peer review process in addition to central ... In this way, reviewers accessing the patient case report form have the medical record, cineangiogram and case reporting form available on a web-based system

http://mhcc.dhmh.maryland.gov/cardiacadvisory/Documents/Proposal%20for%20External%20Peer%20Review%20-%20Dr.%20Miller.pdf

Date added: August 31, 2013 - Views: 3

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

Supervising/collaborating physician Name: _____ Supervising ... This review of records includes the review of prescribing practices by the Advance Practitioner. ... Confidential: Proceedings, Reports and Records of a Medical Peer Review Committee 1 . Title: April 9, 1997

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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Peer Reference Form - Community Care Network of Va

Peer Reference Form Community Care Network of Virginia, 3831 Westerre Parkway, Richmond, Virginia 23233 Phone 804-237-7686 · Fax 804-237-8717 · www.ccnva.com ... Upon review of the applicant’s request for clinical privileges (enclosed) ...

http://www.ccnva.com/wp-content/uploads/2011/10/Web_Peer-Reference.pdf

Date added: April 7, 2014 - Views: 1

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

Supervising physician must periodically review Mid-Level records and complete a peer review form indicating: Medical assessment and diagnosis appropriate Admission to hospital follow guidelines Medications and treatment appropriate to diagnosis

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

Date added: September 25, 2012 - Views: 10

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PEER REFERENCE FORM - PENN Behavioral Health

PEER REFERENCE FORM Name: _____ The above practitioner has made application for appointment to the PENN Behavioral Health Network of the University of

http://www.pennbehavioralhealth.org/documents/peer_reference_form_fillable.pdf

Date added: January 11, 2013 - Views: 5

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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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PATIENTS AND THE PEER REVIEW PROCESS - GSLDS

PATIENTS AND THE PEER REVIEW PROCESS Since you have expressed an interest in using the peer review process of the Missouri Dental Association to resolve a problem between you and your dentist, the following are guidelines and

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

Date added: May 23, 2013 - Views: 1

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The American Board of Plastic Surgery, Inc. - ABPlSurg.org

PEER REVIEW FORM Identification of Reviewer ... At least one form must be completed by the Chief of Staff, ... I believe that this physician is a competent and ethical practitioner and recommend him/her for admission to the examination process.

https://www.abplsurg.org/documents/MOC_2011_Peer_Review_Form.pdf

Date added: March 22, 2012 - Views: 1

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

Peer review, both internal and external, resulted in suspension of privileges ... retrospective chart, second opinion, data review Physician Contract

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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Trauma Center Performance Improvement and Patient Safety Plan

Trauma PI issues will be documented on the “Trauma Review Form” in Appendix C. ... Provider Peer Review-issues identified in the review that deal with specific ... Trauma Director/Other Physician Review:

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

Date added: July 6, 2012 - Views: 12

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REQUEST FOR PEER REVIEW - Alaska

This form must be completed and submitted with the request and fees. Patient’s Name: Date of Birth: ... 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