Current through all regulations passed and filed through September 16, 2024
(A)
Policy
statement
The university of Toledo ("UT")
professional liability insurance program provides coverage to physicians and
certain clinical associates ("insured(s)") of the university of Toledo
physicians, limited liability corporation ("UTP") who practice at practice
locations that have been approved by the executive vice president for clinical
affairs and UT dean, college of medicine and life sciences ("executive VP").
Practice locations owned or controlled by UT or UTP (see appendix A to this
rule) have been pre-approved, however, practice location fact sheets and
procedure checklists do need to be submitted to risk management for entry into
the practice location database.
(B)
Purpose of
policy
To provide a procedure for approving
the practice locations of insureds for coverage under the UT professional
liability insurance program.
(C)
Procedure
(1)
Professional
liability insurance underwriting
An individual's underwriting approval
for professional liability insurance coverage in the UT professional liability
insurance program will not be delayed pending the practice location review
process, however, all attempts will be made to identify and approve the
locations as soon as practical so the insurance program will be able to keep an
accurate, up to date record of the insurance coverage dates and
locations.
(2)
Practice location approval process at the time of
initial hiring or staff appointment
(a)
The administrator for risk management will review the
fact sheets and procedure checklists that are part of the application for
appointment. If any additional information is needed, the administrator for
risk management will obtain it directly from the insured.
(b)
When the fact
sheets and procedure checklists are deemed complete, the administrator for risk
management will attach an approval form to the set of forms for each practice
location requiring approval (i.e. those locations not listed in appendix A to
this rule). This makes up the approval packet for each practice
location.
(c)
The approval packets will be sent to the following
individuals, in the order listed on the approval form. Each individual will
indicate either approval or non-approval and forward the forms on to the next
individual.
(i)
Insured's department chairperson; then to
(ii)
Executive VP;
then to
(iii)
UTP chief physician executive or UTP chief operating
officer; and then return to
(iv)
Administrator
for risk management.
(d)
Approval with
conditions may also be granted. The condition or restriction applying to a
particular practice location will be noted in the comments of the approval
section of the approval form by the individual setting the
condition.
(e)
The completed approval packet (whether approved or
denied) will be returned to the administrator for risk management, who will
then forward a copy to the insured, department chairperson, UTP human resources
and the central verification office (for provider enrollment).
(f)
Risk management
will update its practice location database.
(3)
New practice
location approval process after initial appointment
(a)
An insured
wishing to have a new practice location added to his/her current approved
locations will fill out a fact sheet and procedure checklist for that new
location.
(b)
If the location is not listed on appendix A to this
rule as pre-approved, the Insured will complete the upper part of the approval
form and attach it to the fact sheet and procedure checklist specific to the
location. This makes up the approval packet for that practice
location.
(c)
Paragraphs (C)(2)(c) to (C)(2)(f) of this rule are
completed.
(d)
If the location is listed on appendix A of this rule
and does not require further approval, then the fact sheet and procedure
checklist are sent directly to risk management.
(4)
Annual practice
location audit
(a)
Each insured will be surveyed on an annual basis with
respect to their practice locations.
(i)
On even numbered
years, the administrator for risk management will provide each insured with a
listing of their locations that are in the risk management practice location
database and the insured will update the list as appropriate.
(ii)
On odd numbered
years, the administrator for risk management will provide each insured with a
copy of the fact sheet and procedure checklist for each location that is in the
risk management practice location database and the insured will update the
information as appropriate.
(b)
During the annual
audit, insureds will be instructed to complete a new fact sheet and procedure
checklist for any location where they practice but forms are
lacking.
(c)
Any returned forms that contain significant changes or
any form for a new location requiring approval will have an approval form
attached by the administrator for risk management and will be forwarded for
approval as outlined in paragraph (C) of this rule.
(5)
Appeal process
for non-approval or conditional approval
The insured or department chairperson
may appeal the non-approval or conditional approval of any location to the
individual who disapproved or placed a conditional approval on the location.
The administrator for risk management will be advised of any change in approval
status following the appeal.
(6)
Forms
The following three forms will make up
a practice location approval packet ("approval packet") and will be completed
by insureds for each location where they are seeking to practice.
(a)
Practice location
approval form: This form is used for any location that requires approval and is
not listed on appendix A to this rule. It serves as the cover page that is
attached to each practice location fact sheet and procedure checklist and
documents the approval process for a particular practice location. This form
will be signed off by the insured's department chairperson, executive VP and
UTP's chief physician executive or chief operating officer.
(b)
Practice location
fact sheet: This form must be completed for every location where an insured
intends to practice. It is used to evaluate that particular location's role in
supporting the teaching mission, research mission and strategic mission of UT.
This form is completed for all practice locations, even those pre-approved
locations listed in appendix A to this rule.
(c)
Practice location
procedure checklist: This form must be completed for every location where an
insured intends to practice. It is used to evaluate the type of practice and
procedures that will be done at that particular location and helps establish
the insurance risk rating for that location. The checklist has nothing to do
with credentialing or privileging at that location. This form is completed for
all practice locations, even those pre-approved locations listed in appendix A
to this rule.
(7)
Quarterly practice location reports
The administrator for risk management
will provide the executive VP, UTP chief financial officer and director of the
central verification office a quarterly report of all UTP insureds and their
practice locations.
Replaces: 3364-10-06
Click
to view Appendix
