Requirements For Membership - Physician Criteria

In order to be admitted as a Participating Provider and to remain a Participating Provider, Physician must satisfy the following requirements. Individual Specialties within the Network may have its own criteria as established by Network from time to time that will be in addition to the qualifications set forth in this Exhibit "A."

  • Physician or Allied Health Professional shall be engaged in the active practice of rendering health care; and
  • Physician or Allied Health Professional shall possess an unrestricted current license to practice in the State of Arkansas, Texas, Louisiana or Oklahoma, as applicable to practice; and
  • Physician or Allied Health Professional must have successfully completed residency and/or training requirements at an institution accredited by the Accreditation Council of Graduate Medical Education or other accrediting agency; and
  • Physician or Allied Health Professional must be board certified in his/her specialty, or if not, then board certified, actively pursuing board certification, or must be approved by the Network pursuant to other criteria established by the Network, such as, for example, acceptance to the admitting medical staff for the hospital designated in (11) below prior to a certain date; and
  • Physician or Allied Health Professional must have a current DEA number and state narcotics license, as applicable; and
  • Physician or Allied Health Professional must have and maintain current professional liability insurance coverage with limits not less than the following: (Note: Some payers may require additional limits than listed below)

    $200,000/occurrence
    $600,000/aggregate, and

  • Physician or Allied Health Professional must have a satisfactory professional malpractice history as determined by the Credentials Committee and Board of Directors; and
  • Physician or Allied Health Professional must be currently qualified to participate in Medicare and Medicaid and any other or successor federal, state and/or insurance program enacted in connection with any national health reform initiative; and
  • Physician or Allied Health Professional shall satisfy continuing professional education requirements; and
  • Physician or Allied Health Professional shall agree to, and thereafter satisfactorily participate in, and cooperate and comply with requirements of the PHO Network's utilization review, quality assurance, medical management, credentialing, and any other policies and procedures; and
  • Physician or Allied Health Professional shall be a member in good standing and hold privileges at a PHO Network participating facility within the county of their practice location, however;
    • The following specialties do not require medical staff membership and are eligible for participation in PHO Network:
      • Optometry
      • Psychology
    • Physician or Allied Health Professional who are eligible for privileges at a PHO Network hospital, but have an outpatient only practice or hospital-based practice, must have arranged for coverage of inpatient admissions, if applicable, at a PHO Network hospital in order to be eligible for participation with an Active Affiliate staff status at a PHO Network hospital or to make application for a waiver. The “Physician Without Hospital Privileges” guidelines will be followed.
    • Physician or Allied Health Professional holding privileges at a non-network facility in the PHO Network service area who do not obtain privileges at a participating facility are not eligible to apply for a PHO Network Waiver and do not qualify for participation in Ark-La-Tex Health Network.
  • Physician or Allied Health Professional must abide by the terms and conditions of the PHO Network Provider Agreement, as may be amended from time to time;
  • Physician or Allied Health Professional must abide by the Policies and Procedures and PHO Network Participation Criteria.