A Beginners Guide to Privileging
QUESTION # 4
Is there a CMS requirement for the automatic suspension of a provider ’ s privileges if they do not complete their patient medical records within 30 days post-discharge ?
Enforcing suspension of privileges due to medical records delinquency is at the discretion of the hospital ’ s medical staff . Many hospitals choose to enforce this type of suspension to encourage completion of medical records within 30 days , so they are able to bill Medicare within the required timeframe to maintain their Provider Interim Payment ( PIP ) status .
Tips
• The requirement for completion of medical records should be defined in the hospital ’ s medical staff rules and regulations , or policies for healthcare organizations .
• The provisions for an administrative suspension due to not meeting the requirements for completion of medical records should be defined in the hospital ’ s medical staff bylaws or policies for other healthcare organizations ( if the medical staff or other clinical leaders must enforce this .)
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