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Reporting Malpractice info for credentialing

  1. Default Reporting Malpractice info for credentialing
    Medical Coding Books
    Hi, I would appreciate anyone's thoughts on the following question. When you enter malpractice information most insurance companies want information for the last 10 years. This is fine but one insurance company is telling us that they go by settlement date, not date of occurence. We have been advised previously (and all other insurance companies accept) date of occurrence not date of settlement on a closed claim. I really dont feel that the insurance company should be given details on a 15 year old claim that closed 9 years ago. Please let me know what you think.

  2. #2
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    Insurance companies make their own rules regarding credentialing, so like it or not, you will have to give them the information in the form they requested. It should not make a big difference if the claim was settled 9 years ago.

  3. #3
    Thumbs up
    Quote Originally Posted by ajs View Post
    Insurance companies make their own rules regarding credentialing, so like it or not, you will have to give them the information in the form they requested. It should not make a big difference if the claim was settled 9 years ago.
    I have to agree with AJS. I've been employed on both sides of the fence and while most insurance companies follow NCQH and/or Joint Commission standards for credentialing, some are more demanding and if you want to get on the playground, you have to comply with their credentialing rules. Also, some may ask for claims in the last 5 years, last 10 years, or even "any" claims without a limit on how far back. You may also find these inconsistent requests among some of the hospitals with whom you are seeking priviledges.
    Susan M. Garrett, CPC, COC
    Past President El Paso Texas Chapter AAPC
    Past Member AAPCCA Board of Directors
    cell 915-204-8333

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