Where can I get an application?
Contact Mary Lehr, Medical Staff Coordinator 920-223-2067, mlehr@affinityhealth.org at Medical Staff Services Office.

What does "CV" mean?
Credentials Verification (CV) is the process of receiving and processing practitioners’ applications in accordance with NCQA, CMS, and TJC standards. When an application is received, elements such as license, education, training, board certification, malpractice, sanctions, previous employment, gaps in training/work, references, quality, competency, etc. are verified at the source to ensure accuracy. In addition to, ongoing monitoring of providers’ files.

How long does the application/credentialing process take?
The application process can take anywhere from 30-90 days. The speed of the process depends upon the completeness of the information submitted by the applicant, the response time of the references, and the timing of the Credentials Committee, Medical Executive Committee, and Professional Activities Committee meetings once the application is considered complete.

When does the Credentials Committee meet?
The Credentials Committee (CCC) meets the fourth Tuesday evening of every month.  The Medical Executive Committee (MEC) meets the first Monday of every month.  The Professional Activities Committee (PAC) meets the third Wednesday of every month.

    *Please note these dates are subject to change

At which facilities may I practice?
Ascension maintains an integrated credentialing department; therefore you may practice at any or all of our facilities, Ascension Calumet Medical Center, St. Elizabeth Surgery Center, Ascension Mercy Medical Center and Ascension St. Elizabeth Hospital. Privileges approved will be valid for all four facilities, as appropriate to each facility.

How do I request a change of staff status?
You can fill out a Request for Change in Status/Privilegesform if you desire a change in status or specialty, or wish to resign from the staff.

How do I request a change (add/delete) of privileges?
You can fill out a Request for Additional Privileges or Request for Change in Status/Privileges form if you desire to add a new privilege or relinquish a seldom used privilege.

How do I request a Leave of Absence?
Any practitioner who will be absent for one month or longer must apply for leave of absence from the medical staff in accordance with medical staff policy.   A practitioner who is ready to return from leave of absence must submit a written request for reinstatement to the Medical Executive Committee. You may be asked to provide additional information per the Medical Leave of Absence policy.

Who am I required to notify regarding change of address, etc.?
Changes in demographic information should be forwarded to Mary Lehr, Medical Staff Coordinator 920-223-2067, mlehr@affinityhealth.org at the Affinity Health System Medical Staff Services office.