LICENSURE, CREDENTIALING, AND ENROLLMENT

Overview
Medical Staff Privileges
Enrollment
Licensure Information
Questions

Overview of Physician Recruitment, Medical Staff Privileges and Insurance/Managed Care Company Credentialing Processes

As you explore career opportunities at Cambridge Health Alliance (CHA), The Department of Physician Recruitment would like to provide you with some general information you will need to navigate the through the employment process. We believe this information will greatly assist you no matter where you choose to work.

As you proceed through the interview process, there are several things that need to occur prior to extending an offer as well as sending a formal offer letter. As you review the below information, it is important to note that there can be special circumstances which will prevent all the requirements to be met. These deviations will be considered on an individual basis: however, the outline below is our approved process which we strive towards for the majority of the candidates we hire.

Before a verbal offer can occur, ideally we would like to have the following information:

• Three verbal references need to be conducted by the hiring Chief. References must be from Physicians and one should be from a MD Director/Chief or Program Director

• A copy of your most recent MA license renewal or full application. If you are currently practicing in another state, and are in the early stages of applying for a MA license, then a copy of your current state application will suffice

• Two written references (should be mailed/faxed to the Department of Physician Recruitment)
  

The list of references, reference letters and the MA license application can be given to the Dept. of Physician Recruitment at any time during the interview process. Additionally, these documents must meet with the standards and protocols of the CHA's Dept. of Physician Recruitment.

MEDICAL STAFF PRIVILEGES

Once you have verbally accepted a position at Cambridge Health Alliance, our Medical Staff Services Department will send you a credentialing packet to complete. Your employment with CHA is only granted once you meet all credentialing requirements and receive appointment to the medical staff. The following are the list of documents required for obtaining staff privileges at the Cambridge, Somerville and Whidden Hospital campuses.

These documents you will need to supply and return in your completed packet:

• MA Medical License (wallet size)
• MA Medical License application. Most recent full or renewal application.
  
• DEA
  
• MA State Controlled Substance Certificate
  
• ECFMG (when applicable for physicians with a foreign medical school training )
  
• Current malpractice face sheet (minimum 1M/5M)
  
• List of three references to complete a written reference
  
• Date of Interview with Chief or Department
  
• CV (must be in month year format)

These documents will be mailed to you to complete in the packet:

• Completed and signed Application for Appointment
  
• Completed and signed Delineation of Privilege for
  
• Signed CORI with photo attached
  
• Signed Medicare Attestation Statement
  
• Signed/Completed Reasonable Inquiry Authorization
  
• Recent Photograph

ENROLLMENT IN INSURANCE/MANAGED CARE PLANS

At Cambridge Health Alliance, overall responsibility for ensuring you are properly processed with the various insurance plans rests with the Provider Enrollment Department. CHA's Provider Enrollment works closely with the Medical Staff Services Department so as to minimize duplication.

Provider Enrollment process is key aspect for making sure that we meet our responsibility to assure the quality of the providers in our practice and is the mechanism by which we receive payment for services provided. Providers can only receive their specific number from the insurer and each insurer has different applications for different numbers.

Without properly submitting documents/forms, you will delay your start date and your ability to see patients and bill for those services. Additionally should you provide medical services to patients without your specific ID, the following will occur:

• CHA will be in breach of provisions insurance contracts
  
• Authorization for services will not be given
  
• Claims for services that require a referral will be rejected
  
• Primary Care Physician cannot have a panel

Depending on your anticipated start date, a packet of information will either be mailed to you separately or will be included in your offer letter packet. Our Provider Enrollment Staff will pre-fill as much of the information as possible for you and when at all possible, they will schedule time to meet with you on an individual basis.

LICENSURE INFORMATION

Massachusetts License Application

• License application can be downloaded from the MA Board of Registration 617-654-9810. Visit www.massmedboard.org and click on Physician Services. Takes 8-12 weeks.

Massachusetts Department of Public Health

• The Commonwealth of Massachusetts Department of Public Health is at http://www.mass.gov/dph/ or 617-983-6712. Takes 2-3 weeks.

Federal Drug Enforcement Agency (DEA)

• US Drug Enforcement Administration is at www.usdoj.gov/dea or 617-557-2200. Takes 6-8 weeks.

QUESTIONS ABOUT THE PROCESS

One of the key roles for the Department of Physician Recruitment is to work with you every step of the way during this entire process. We strive to be a competent resource for you will assist you in every aspect of the employment process. Any questions regarding this process, please do not hesitate to contact Laura Schofield, Director of Physician Recruitment at 617-665-3149.