Schedule Hours for Clinic /Hospital12Schedule Days Clinic /Hospital1Number of patients seen per day in clinic0Call Night /Weekend -yesWhat are the days for CallSat SunWhat Time does the Call start7:00 AMWhat Time does Call end7:00 AMCall will be for assigned, unassigned, or both assigned and unassigned patientsyesCall response time required?( 15 min? 20 min?)15 minCall Ratio Call Back %100%Average Phone consults while on call3Average admissions while on call1Average patients seen while on call3If there are specific dates you need filled please include them here along with the shift times - for example 6/1-5 8a-5p with night call 5p-8a 1/7/2023Age of patients (Must specify if the provider will see patients under 18) -under 18Inpatient /Outpatient -inpatientType of Charting /EMR -EPICBoard Certified or Board Eligible -CertifiedIs Fellowship requiredyesHow Long Does Credentialing Take - (90 days per CVO) 90 daysAre Temp Privileges Granted -yesTravel and Lodging (is there a Corp Rate somewhere?)yesBeds in the Department135Admissions RequiredyesAverage Number of Admissions per shift (when not on call)-2Is the Hospital Stroke CertifiedyesIs there Rounding? IF so is it for assigned or unassigned patientsunassigneddIs an active state license required in order to be considered? yesWill you consider providers with an IMLC? (compact lic)noThe Following Certifications Are Required? ABLS,ACLS,ATLS,BLS,PALS (any others please specify) Pediatric SurgeryWhat PEDs Level is the facility 3,2,1?1What Trauma Level 1-5?1Support staff (How many and which) RN? MA? PA/NP? Office Staff?0Is the Hospital Stroke CertifiedyesIs there Rounding? IF so is it for assigned or unassigned patientsunassigneddWill you consider providers with an IMLC? (compact lic)noThe Following Certifications Are Required? ABLS,ACLS,ATLS,BLS,PALS (any others please specify) Pediatric DurgeryWhat PEDs Level is the facility 3,2,1?1What Trauma Level 1-5?1Support staff (How many and what) RN? MA? PA/NP? Office Staff?0Call will be for assigned, unassigned, or both assigned and unassigned patientsunassigneddCall response time required? 15 min? 20 min?100%Call Ratio Call Back %15Average Phone consults5Average patients seen while on call5Average admissions while on call2
