Rule 3364-10-06 | Practice location aproval.
(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.
Last updated June 25, 2021 at 7:06 PM
Supplemental Information
Amplifies: 3364
Prior Effective Dates: 10/26/2018, 8/24/2020