H: Hello, my name is Hans Edenfield. I am the director of Human Resources and Operations with D&Y. Today I have with me Angel Perry, who is our team administrative lead for our licensure department, and we’re going to be talking regarding how our licensure department may be of assistance to a provider and help them or facilitate their obtainment of a needed medical license from a state. So Angel, are you ready to go?
A: I’m ready!
H: Alright, so first question is for a provider – is there really any advantage to using a licensing agency rather than applying on my own?
A: I think that there definitely can be an advantage. I think a provider needs to consider several factors when deciding if they want to use a licensing agency or apply on their own.
They need to think about how much time they really have to work on a license – licensing can be very time-consuming, there’s a lot of paperwork involved. The boards do require all primary source verification, and that requires contacting schools, facilities, and references for that documentation to be sent back to that medical board.
Also, how complicated is the application? Is it a 4-page application, is it a big 37-page application that’s going to take you a couple of hours to fill out? Here at D&Y, we have a dedicated team of licensing professionals who deal with state licensing boards on a daily basis, and we are trained in how to fill out the applications properly, what questions to ask, who to contact for information. So, it can definitely be to your advantage to request assistance with licensing.
H: That’s very helpful information, Angel. You alluded to the fact that we can help complete the application on behalf of the provider, so how else can D&Y help with the licensing process?
A: Well, what we can do is pre-fill the application, do all the paperwork that’s needed whether it’s part of the application or separate, and get that to the provider so that they can easily fill it in. They know what they have to put in there, they can get that filled in and sent back to D&Y.
Once we get it back we will send that to the medical board, we’ll send out the verification request, we will do all of the follow-up calls. Some examples of primary source verifications that are required by medical boards are:
Those are all things that we here at D&Y would assist in obtaining and getting to the board, so that the license could be facilitated and issued in a very expeditious manner.
H: Wow, that’s a lot of moving parts. So, what documentation or information does a provider need to have when applying for a license?
A: So, when they’re applying for a license, there’s certain information that’s going to be needed at every state medical board, and then there are a few that are more state-specific.
Every medical board is going to require a chronological history with accurate dates. Now, some states may want your history from high school to present, others may want from medical school to present, but all states are going to want some type of chronological history with no gaps.
So that means that every provider should be keeping an accurate record of everywhere they have worked, even if it’s just for a few days on a locums assignment. They need to keep track of those days, where they worked, what city and state those places were in. You know, an Excel spreadsheet would be an excellent way to track that information. If they put the address for the facility in there, that’s great too, that can be very helpful. If a facility closes and they know that and they put that on there, that’s also very helpful. That’s something that every state is going to need.
If a provider has any malpractice, if they’ve been sued – whether it resulted in a settlement or not – the state medical boards do require documentation and explanations regarding those malpractice claims. So it’s very important to keep track of both your court documents (which would include both an initial complaint filed with the court), any settlement documentation, who your attorney was, what court system was it filed in, the plaintiffs’ names, the defendants’ names.
All of that information can be very important when you apply for licensing because the boards do require that now. Sometimes we even have to get certified documents, and if we have to get certified documents we have to know what court system we have to contact to get that documentation.
All providers should keep track of their previous and current malpractice insurance carriers. There are certain states that do require lists of all previous and current carriers with policy numbers and dates of coverage. Again, an Excel spreadsheet or even a Word document is an excellent way to keep track of that information – you can just update it as you go.
If there are any arrests, investigations, or board actions, you need to be sure to keep any relevant documentation such as arrest reports, official letters. You’ll likely have to disclose this information probably for the remainder of your career on any licensing application. If you had an attorney, you need to keep that information, any court documents, keep that. You’ll need to write an explanation from your point-of-view, and keep that in the same file. You can scan this information and put in on a thumb drive, or keep a paper file. Either way, it’s very important to keep all that information with the dates, the initial incidents, and the final disposition of the case.
You need copies of all of your relevant information for licensing, and that includes things such as
There are sometimes other specific documentation that can vary state-by-state, but those are the most commonly requested documents.
You need to know what licensing exam you took. Every physician will have taken some type of national licensing exam, and that could have been the USMLE, NBME, Comlex, NBOME, Flex, or possibly a state exam. You need to know which exam you took, the dates of any steps for each exam – such as the USMLE which has 3 steps, you need to know the date that each step was taken – if you passed, how many attempts did it take to pass, and possibly even the location that you took that exam. So, those are some of the things that are very important to keep track of for all physicians and providers.
H: That’s very helpful information, very practical guidance there. Thank you. So there’s been a lot of news recently regarding the new physician compact. Can a provider apply for state licensure using the compact?
A: Not currently. The compact is still currently in the works. They do have a target date of January of 2017 for qualified physicians who are going to be able to apply at that time. They have not formally said that January is going to be the start, but that is their target date. (Update 5/10/19: the Interstate Medical Licensure Compact is now available for physician licensing in 29 states.)
There are currently 18 states that are in the compact, and those include: Montana, Wyoming, Idaho, Nevada, Utah, Colorado, Arizona, Kansas, South Dakota, Minnesota, Iowa, Wisconsin, Illinois, Mississippi, Alabama, West Virginia, Pennsylvania, and New Hampshire.
Physicians must be well-qualified – already possessing a full and unrestricted license in one of the states that I just mentioned, which would be considered a compact state.
To get an IMLC license, you have to have:
So, if for some reason you don’t meet those requirements, you can still apply for licensure through any of those states through their regular process. The compact is just going to be an expedited process for those highly qualified physicians. Currently, they are setting up all of the fees, the documentation, and the paperwork, and hopefully we’ll have an update on that in January to give to people on their progress.
H: That’s a very exciting development. So, in other words stay tuned and check back, correct?
H: All right, so we hear the term “FCVS”. What is the “FCVS”, Angel?
A: So, the “FCVS” is the Federation Credentials Verification Service. It was set up in 1996 to be a storing house for a physician’s basic credentials. That would include their:
It’s used by the state as a primary source verification, and that can be potentially very important got an IMG physician.
There are currently 12 states that actually require the use of FCVS. Those states are: Nevada, Utah, Wyoming, Louisiana, South Carolina, North Carolina, Kentucky, Ohio, New York, New Jersey, Maine, and Rhode Island. That means in those states every physician who applies for licensure must have an FCVS profile that is set up.
It does cost about $500 to set up an initial profile, and it can take anywhere from between 2 to 6 months, just depending on the complexity of the information that the FCVS is having to verify. If you already have an established profile, it only costs about $200 to send a copy of that to any of the state medical boards.
Once the state medical boards have that information it can significantly shorten the amount of time required to get a license, especially for those IMG physicians as we stated. As I said, the state of Alabama would accept the FCVS in lieu of having to obtain the documentation directly from an out-of-country medical school. That can definitely be a shorter time frame.
H: Very helpful information, thank you, Angel. Our last question is: is there a difference in a DEA and a state-controlled substance license?
A: Yes, there is. Although the state-controlled substance license and the DEA are licenses to write prescriptions on controlled substances, the DEA is the federal license.
The state-controlled substance license is of course a state-level license, and not all states have a state-level substance license. If they do, you have to obtain the state-controlled substance license in addition to the federal DEA.
The federal DEA costs $731, it’s good for about 3 years. The cost of the state-controlled substance license is going to vary from state-to-state; anywhere from $5 to $420.
H: That’s a pretty big spread.
A: It is a big spread. They’re regulated by the state, so it’s whatever they decide.
You can hold more than 1 DEA, even in the same state. So, if you are in the state of Alabama, you can hold a DEA that has Huntsville Hospital listed as an address, as well as one that says Mobile, Alabama – you know, Mobile Infirmary as a business address.
You are required by federal law to have a DEA with a business address in the state that you are practicing in and that address has to be listed on the DEA registration. So, for example, if you are practicing in the state of Alabama, you would need to have a DEA that had an Alabama address on it.
Now, if you were practicing at Huntsville Hospital, your DEA had “Huntsville Hospital” written on it, and you decide to go to Mobile Infirmary, you don’t actually have to change the address from “Huntsville Hospital” to “Mobile Infirmary”. It’s not required by federal law, it’s just required that you have an address in the state that you’re practicing in, and the address must match the address on the state-controlled substance license, if applicable. So, if you’re in a state that has a state-level controlled substance license, the address on that license must match the address that you put on your DEA.
H: Good information to know, very helpful. Well Angel, that concludes our questions at this point. You’ve been very helpful and provided a lot of good insight to our physician population should they need assistance in obtaining their medical license, as far as how D&Y can help facilitate that process. Again, Angel, thank you so much. We’ll talk soon.
A: All right, thank you.
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