Kathy Matzka

Description	File
Sample Bylaws Language for Temporary Privileges Under TJC CAMH Standards. This language can be used to update bylaws to comply with The Joint Commission's medical staff standards for granting temporary privileges.	Bylaws Language (20KB)
Sample Human Resources Policy for Students Participating in Medical Training.	Human Resources Student Policy (20.5KB)
Sample Policy and Process for Credentialing and Privileging of Non-independent APRN and PA Practitioners through the Human Resources Department	Credentialing and Privileging Non_LIP.doc (36KB)
Sample Form for Requesting Primary Source Verification From Hospitals. This form incorporates an evaluation based on the ACGME's Core Competencies.	Sample Hospital Reference Letter (75.5KB)
Sample Peer Recommendation Letter. This form incorporates an evaluation based on the ACGME's Core Competencies.	Peer Reference Letter (73.0KB)
Credentials File Audit Form for Compliance with Joint Commission Medical Staff Standards for Credentialing and Privileging. This can be used by hospitals to evaluate their own compliance with standards or to audit contractual services under TJC standards.	Chart Audit Form (120KB)
Credentials Committee Orientation PowerPoint Presentation. Customize this presentation for use in orienting your credentials committee members to your facility's credentialing and privileging processes.	Credentials Committee Orientation PowerPoint Presentation (72.5KB)
Letter and Chart for Documentation of Compliance with Joint Commission Medical Staff Standards for Contract Services Providers. Use this letter and form to ask contracted service providers to document compliance with The Joint Commission's Medical Staff Standards for Credentialing and Privileging	Chart for Documentation of Compliance with Joint Commission Medical Staff Standards for Contract Services
Structured Interview Form. Use to standardize the interview process for new applicants.	Structured Interview Form
Telephone Interview Form for Affiliation. Use to document telephone verifications for medical staff applicants.	Telephone Interview Form - Hospital
Telephone Interview Form for Peer Recommendatino. Use to document telephone/verbal peer recommendations.	Telephone Interview Form - Peer