Credentialing disputes involve challenges to privileging decisions, typically alleging that the hospital failed to follow its medical staff bylaws, acted in bad faith, or was motivated by economic rather than quality concerns.
Bylaws generally establish an internal hearing process before litigation.
Alternative Names:
Credentialing Dispute, Privileges Dispute
Why it Matters?
Exhaustion of the bylaws process is a threshold requirement in most jurisdictions, which means a physician who files suit without completing the internal hearing faces dismissal. The economic credentialing theory, alleging that competitive rather than quality concerns drove the decision, is the recurring substantive claim. Immunity under the Health Care Quality Improvement Act is the hospital's principal defense where the process requirements were met.
Frequently Confused with
Related terms
Frequently asked questions
Must the bylaws process be exhausted first?
What is economic credentialing?
