Department of Medicine Temporary Med Staff Privileges
Division, Department, Chief of Staff, and Medical Director:





The Division Head sends email/memo to Service Chief (Dr. Anawalt/Dr. Broudy) with a
request to issue temporary privileges to a physician, based on an urgent clinical need.
The Service Chief forwards this email to the Chief of Staff Elect, Dr. Jo Davies
Once the Chief of Staff reviews and gives approval, the request is forwarded to the
Medical Director(s) at the facility where temporary privileges are requested (UWMC,
HMC, SCCA)
The Medical Director responds with his/her approval and lets OMSA know that approval
has been given to process temporary privileges
The Division Coordinator fills out the “Request for Temporary Medical Staff Privileges”
(available online, at DoMWeb) and forwards the form for Service Chief’s signature.
Service Chief’s office submits form to OMSA.
OMSA:








Verifies approval
Obtains Provider ID and billing number
Runs NPDB (National Profile Database)
Verifies medical license/expiration date
Establishes Board certification and highest level of training
Obtains WA state criminal history background check
Verifies existing privileges
Forwards completed request for temporary privileges along with the initial application
packet to Medical Director’s office along with attestation, 3 letters of reference,
immunization form, patient confidentiality and privilege form
Credentialing Committee:

The facility’s (or facilities’) credentialing committee (at UWMC: Medical Staff Advisory
Committee, aka MSAC, at HMC: Medical Executive Board, aka MEB) votes on awarding
the Temporary Privileges (UWP/NCQA); three votes are needed
Once the Medical Director’s office notifies OMSA that the committee has approved the
application and that Temporary Privileges have been granted, OMSA sends out emails to the
provider, the Department Chair’s office, UWP, and the Division.
Provider will be on Temporary Privileges until the full committee approval process for a final
vote on the initial application has been completed.