Credentialing

Initial Application

To request an initial application, please fill out the form. Once the request form is submitted, a Silversheet connection request will be sent via email to the address provided on the form.

Statement: A direct e-mail address is required and will be used for credentialing purposes and for other purposes if a legitimate need has been identified with the understanding that it is not to be used for publication or distribution to other organizations or individuals. The credentialing process may require email communications about confidential information. Applicant should provide an appropriate email address to maintain their confidentiality.

Initial Application Packets Include:

  • Electronic application with consent for release and attestations
  • Electronic delineation of privileges/privilege request form
  • Peer Review Confidentiality Agreement
  • Infection Control & Safety Education
  • Injection Safety Competency

Documents to be submitted with your application:

  • CV
  • Copy of current state license, DEA, and Fluoroscopy/Radiography Certificate (If applicable)
  • Professional Liability insurance policy & Certificate of Coverage from insurance carrier (minimum amounts of liability: $1,000,000/$3,000,000)
  • ECFMG Certificate (if foreign medical graduate)
  • M.D./D.O./D.D.S./D.P.M./Ph.D. Certificate
  • Internship, Residency, Fellowship certificates (if available)
  • Evidence of specialty board eligibility status or certificate
  • Documentation of CME (min 50 credits x past 2 years)
  • Copy of current or most recent hospital privileges (only applicable to those not on WHHS Medical Staff)
  • List of procedures performed during the past 2 years

Application Process:
Initial applications can take up to 60 days to process and complete. Once all verifications and required documents have been received, the application is prepared for Credentials Committee review. The Committee members will then give recommendation to the Board for final approval of privileges on the Washington Outpatient Surgery Center Medical Staff.
When approval has been granted, a letter from the Medical Director and a copy of your approved privileges will be sent via Silversheet and email; physicians/physician assistants may then begin scheduling with our Center. All physicians are required to undergo proctoring for their first 6 cases at the Center. An assigned proctor will be appointed to you in your approval letter. It is your responsibility to coordinate with your proctor to attend the cases.

Reappointment

Reappointment to the WOSC Medical Staff/Allied Health Staff is every 2 years and coincides with state license expirations. The reappointment application is prefilled with the information that was provided at initial appointment. Any updated information will need to be submitted at this time.
Reappointment Packets Include:

  • Electronic application with consent for release and attestations
  • Electronic delineation of privileges/privilege request form
  • Peer Review Confidentiality Agreement
  • Copy of current hospital privileges (only applicable to those not on WHHS Medical Staff)

Document Maintenance

All documents, licenses, certificates, etc. can be updated in Silversheet directly or they may be emailed to credentialing@washosc.com.

CVO Service:

WOSC uses Silversheet’s credentialing software to maintain all Medical Staff/Allied Health Staff files. Physicians/Physician Assistants will have access to this system with their own profiles. Office Managers, or office staff, may be assigned as a delegate on your account to assist with updating and submitting credentials.
Login: https://silversheet.com/sign_in
Blog (includes instructions): http://blog.silversheet.com/

Contact Info:

Phone: 510-494-5628
Fax: 510-790-8916
Email: credentialing@washosc.com
*All verification/affiliation requests may be sent to the email listed above.

 

GET IN TOUCH

 

  • * All indicated fields must be completed.
    Please include non-medical questions and correspondence only.
  • This field is for validation purposes and should be left unchanged.