Medical Staff Services

Welcome to Medical Staff Services at Atrium Health, where through a partnership approach, we are committed to providing a seamless credentialing experience for both the medical staff and advanced practice providers.

Credentialing Process

Through our Centralized Verification Office (CVO) we have established a uniform application which collects information for both clinical privileges and payer enrollment that includes commercial managed care and government payers. Due to the time-sensitivity of this information and levels of approval, it is imperative that you submit your application with all supporting documents within 10 days to avoid potential delays in your scheduled start date. Once you have exceeded 10 days we will work with your onboarding team to identify a new start date which may interfere with previously established contractual expectations.

To ensure that you receive the needed support you will be assigned a personal Intake Coordinator who will partner with you in document and data collection, and a Credentialing Specialist who will perform all of the needed research on your behalf for both Initial Appointment and Reappointment.

Overall, our efficient credentialing process occurs in three phases which include:

• Phase I: Intake and Data Collection
• Phase 2: Research and Primary Source Verification
• Phase 3: Approval and Enrollment

Let’s Get Started!

1. Review the credentialing process.
2. Collect all documents needed for credentialing process using the credentialing checklist.
3. Email Medical Staff Services to initiate the application process.
4. Monitor real-time updates of your credentialing application via the Credentialing Status Portal.

Additional Credentialing Services

Physician/Dentist Forms:

• Community/Affiliate Provider Information Form - If you are a provider who is not currently employed by Atrium Health.
• Classification/Clinical Privileges Request Form - If you are currently a member of the medical staff and need privileges for a new facility or to change current classification. 
• Delineation of Privileges (DOP) Request Form - Changes are needed to current privileges. 
• Return From A Leave of Absence Request - A formal request to return is required following a leave of absence.
• Proctoring Policy and Request Form - Physicians requesting proctoring within Atrium Health facilities.
• Proctor Evaluation Form - At the completion of the proctoring term, an evaluation form is completed by the proctor and forwarded to proctoree. 
• Proctor Evaluation Form (PDF version)
• Professional Demographic Change Form - Change of address, practice and/or name.

Advanced Practice Providers (APP's):

• Clinical Practice Update Request Form - All change requests for APP’s including additional facility request, change in supervising physician, changes to your Delineation of Privileges (DOP) and change in specialty. 
• Proctoring Policy and Request Form - Advanced Practice Providers requesting proctoring within Atrium Health facilities.
• Proctor Evaluation Form - At the completion of the proctoring term, an evaluation form is completed by the proctor and forwarded to proctoree.
• Proctor Evaluation Form (PDF version)
• Professional Demographic Change Form - Change of address, practice and/or name.

Physician/Dental Support Staff (PDSS):

• Physician/Dentist Support Staff Request Form (DAs, Scribes, Scrub Nurse, Surgical Tech, etc.) - To request to serve as support for members of the medical staff. 

Clinical Pharmacist Practitioner (CPP):

• Clinical Pharmacist Practitioner Request Form - to request to serve as a clinical pharmacist practitioner (CPP) at Atrium Health.

Verifications

Hospital Privilege Verification

The Atrium Health Medical Staff Office has established an online Verification Lookup Portal that is secure, free of charge, quick and easy access to an affiliation letter for the following Atrium facilities: Carolinas Medical Center (which includes Atrium Health Mercy), Atrium Health Pineville, Atrium Health University City, Atrium Health Union, Atrium Health Lincoln, Atrium Health Cabarrus, Atrium Health Cleveland (which includes Atrium Health Kings Mountain), Atrium Health Stanly, Atrium Health Anson, Carolinas Rehabilitation, Atrium Health Surgery Center Indian Trail, Atrium Health Surgery Center Shelby, and The Center for Orthopaedic Surgery.

Instructions for the Verification Lookup Portal

1. Login to the Verification Lookup Portal.
2. Click the dropdown and choose the Facility (Required Field).
3. Type in the providers Last Name (Required Field), First Name and NPI to narrow the search.
4. Type in your name in the Requester area (Required Field). You may include other information about yourself if you wish.
5. Place a checkmark in the box for the Legal Statement at the bottom of the page.
6. Click Search.
7. Click on your provider's name.
8. Print the affiliation verification indicating the status of good standing.
9. If no letter is available for the practitioner you are verifying, please contact us at 704-355-2147 or MedicalStaffServices@AtriumHealth.org.

Medical Staff Education PowerPoint

• Open and review the Medical Staff Education PowerPoint which relates to Medical Education for EMTALA, Emergency Management, Corporate Privacy, Pain Assessment and Management, Antimicrobial Stewardship, Infection Prevention and Restrictive Interventions. 

Residency/Fellowship Training Verification

Requests to verify a GME resident's or fellow's training at Atrium Health are processed by the individual program where the resident/fellow completed that training. Please contact programs directly with your verification inquiries; the Medical Staff Office does not complete verification of training forms.

Certificate of Insurance Verification

To request your loss run history during your tenure at Atrium Health, email the Corporate Risk Management office.

Free Standing Emergency Department Ambulance Patient Transfers/Transports Education

In order to provide our patients with the highest quality patient care and experience, we must ensure patient’s conditions meet medical necessity criterion (as articulated by Centers for Medicare/Medicaid) to determine if ambulance transport or transfers are reasonable and necessary.

If you are able, post the process infographic in a clinical space where you can readily access this material as needed.

Share with your respective care teams and reinforce in routine huddles or as you are able.

Further questions regarding these education materials? Contact Todd Anderson.