Credentialing and Privileging Procedures at UWHC Michael L. Bentz MD, FAAP, FACS President, UWHC Medical Staff Professor of Surgery, Pediatrics and Neurosurgery Chairman, Division of Plastic and Reconstructive Surgery Vice Chairman of Clinical Affairs, Department of Surgery

Overview Approval Process for: New Applications Additional Privileges Applicant Approval Process for: New Applications Additional Privileges Status Changes Reappointments Complete Application Department Chair Review Application & Make Recommendation UWHC Credentials Committee Review Application & Make Recommendation UWHC Medical Board Review Recommendations & Make Recommendation UWHC Authority Board (Board of Directors) Review Recommendations & Approve Request

UWHC Credentialing Process: New Applications MD Applicant Department Chair Creates Physician SetUp Form, Requests Privileges Application Medical Staff Affairs Office United Credentials Committee Office Nat’l Practitioner Databank Query Criminal Background Check Verify Faculty Appointment Evaluate Health Status Responses Primary Source Verification of: License Education Training Affiliations Malpractice Board Certification UWHC Credentials Committee United Credentials Committee Members UWHC Medical Board UWHC Authority Board

UWHC Credentialing Process: Additional Privileges & Status Change MD Applicant Department Chair Medical Staff Affairs Office UWHC Credentials Committee UWHC Medical Board UWHC Authority Board

UWHC Credentialing Process: Reappointments Medical Staff Member Completes reappointment application Medical Staff Affairs Office Verifies: WI license Board Certification DEA Volume Reports Completeness of Applications, Risk Management Education and Annual Safety and Infection Control Department Chair Completes Evaluation and Makes Recommendation UWHC Credentials Committee UWHC Medical Board UWHC Authority Board