Medical Staff Services Office

Request an Application

To request an application for medical or associate professional staff privileges and/or membership, fax your request to 413-794-0306, email the Medical Staff Office or send a written request to:

Medical Staff Office
280 Chestnut Street, 5th Floor
Springfield, MA 01199

Please include the following contact information:

• Name
• Practice Name (Address, City, State, Zip, Phone and Fax Numbers)
• Date of Birth
• Email
• Privilege type and the associated facility (BMC, BFMC, BNH, BWH)

NOTE:  Application fees are as follows:  one hospital: $200.00, two hospitals: $300.00, three hospitals: $400.00 and four hospitals: $500.00

Reappointments

Reappointment is the re-verification and/or re-privileging of a provider’s competence.  Reappointments are completed every two years; about four to six months prior to the expiration of your current privileges and/or membership.  The medical staff office will email a link at the appropriate time.

NOTE:   The Joint Commission standard requires providers complete the reappointment process every 24 months.  If a provider does not complete the reappointment on time, the provider’s reappointment will expire and they can no longer work or see patients in any Baystate Health facility.  If a provider’s reappointment expires, the provider’s privileges lapse and the provider must complete the initial application process in order to be appointed to the medical staff and to treat patients at the privileged Baystate Health facility.

Expirables 

(includes licenses, renewals, certificates (MA controlled substance, Federal DEA, Basic Life Support), Malpractice insurance factsheet)

Medical Staff bylaws at each hospital (Baystate Medical Center, Baystate Franklin Medical Center, Baystate Noble Hospital, and Baystate Wing Hospital) require providers to maintain current Expirables at all times. Failure to renew license or insurance will result in the suspension of medical staff privileges at the privileged hospital(s) until renewal is verified by the Medical Staff Office. The Medical Staff Office (MSO) monitors expiration dates and requests renewals from providers at 60 days, 30 days, and 2 weeks prior to expiration. Please see the following policy for details:

• First Reminder -- A first reminder will be emailed (60) days prior to the document(s) expiration date to the provider’s contact if available otherwise directly to the provider.
• Second Reminder – A second reminder will be emailed (30) days prior to the expiration date directly to the provider.
• Third Reminder – A third and final reminder will be emailed (2) weeks prior to the expiration date directly to the provider.
  A Week (1) Prior to the Expiration Date – If the document(s) has not been received in the MSO, you will be placed on our Pending Suspension notice to the Chief and Chair of the Department.
  
  If the document(s) is not received by 10:00 AM of the expiration date you will be placed on suspension until the updated document(s) is received by the MSO. If the expiration date of the document falls on a Saturday or Sunday you will be placed on suspension on that Friday at 10:00 AM prior to the weekend.
  
  The email address to send documents and licensure is msoexpirables@baystatehealth.org.

A NOTE ON MA CONTROLLED SUBSTANCE CERTIFICATES

In the event that your MA Controlled Substance registration expires while the Department of Public Health (DPH) is processing your application, under M.G.L. Chapter 94C, section 7, your registration continues in full force and effect unless it is suspended or revoked. As such, you may still prescribe controlled substances pending receipt of your MCSR recall or renewal certificate. Until your MCSR recall or renewal certificate arrives, please keep the Notice or Receipt of Recall or Renewal Application, and a copy of your cancelled check (front and back) as proof that your application was received and is in process.

For additional information contact the Drug Control Program at (617) 973-0949 or send an email to mcsr@massmail.state.ma.us. Thank you!

A NOTE ON MA LICENSE RENEWAL APPLICATIONS

Medical Staff Executive Committee

The function of the Medical Staff Executive Committee is to represent and act on behalf of the medical staff in all matters, except those otherwise provided in the medical staff bylaws and to be consistent with The Joint Commission standards. In addition, the Committee receives, coordinates, and acts upon appropriate recommendations of the clinical departments, standing and special committees and any reports deemed necessary or appropriate. The Committee also coordinates activities and policies adopted by the medical staff, the Committee recommends to the Board of Trustees medical staff appointments, reappointments, medical staff categories, department assignments, clinical privileges and disciplinary actions while assuring professional and ethical conduct and competent clinical performance of medical staff members. The Committee also makes recommendations to the CEO on medico-administrative, medical center management and planning matters.

Membership:

Credentials Committee

The function of the Credentials Committee is to coordinate the medical staff credentialing process by analyzing applications, making recommendations and overseeing the maintenance of individual credential files. In addition the Committee is responsible for integrating quality and utilization assessment, monitoring membership, reviewing and recommending to the Medical Staff Executive Committee approval for delineating clinical privileges for providers. The Committee also develops, coordinates and periodically reviews recommendations on the procedures and forms that are utilized in the credentialing process and the design and oversight of the credentialing procedures.ures.

Membership:

Pharmacy and Therapeutics Committee

The function of the Pharmacy & Therapeutics Committee is to fulfill medical staff responsibilities and functions relating to pharmacy and therapeutics policies and practices. Membership: