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How To Submit a Moonlighting Waiver to CRICO

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How To Submit a Moonlighting Waiver to CRICO

By Underwriting

 

 
 printablewaiver  quickref  enroll
Printable
Waiver
Quick
Reference
Guide
External User
Enrollment Form
           

 

Duration: 4:20

This is a video walk through of how you fill out CRICO’s moonlighting waiver.

Transcript

Moonlighting waivers need to be completed and submitted to CRICO Underwriting on behalf of residents and fellows who will be practicing outside the CRICO network. The quick reference guide shown here is also available on the website after the transcript of this video. For more in-depth physician requirements, refer to the Moonlighting Coverage section of the Underwriting Manual.

 

Now we will go through the moonlighting waiver step-by-step.

  1. Check either the fellow, resident, or resident, emergency medicine box which corresponds to the physician seeking the extension of coverage.
  2. Choose the physician’s sponsoring institution from the options. This is the CRICO member or sponsor which provides CRICO coverage for the resident or fellow. Please note that only one of these options should be selected.
  3. This section is where you should list all locations outside the CRICO network where the resident or fellow will be moonlighting. You do not need to include the sponsoring institution in this list. Additionally, you do not need to include any federal facilities such as VA medical centers. Providers practicing at federal locations are protected by the Federal Tort Claims Act (FTCA), and CRICO coverage is not necessary.
  4. In the next section, list the dates for which the physician is moonlighting.
  5. If the resident or fellow will be practicing part-time in an emergency room outside of the Harvard Medical Institutional System, check Yes. Otherwise, choose No.
  6. If you selected Yes, please complete the fields for ACLS, PALS, and ATLS certifications. You can refer to the quick reference guide previously shown or view the Moonlighting Coverage section of the Underwriting Manual for more details on what is required.
  7. At the bottom of the first page, please ensure that the waiver is signed by the resident or fellow and the Chief of Service. Be sure also to include the printed name of the Chief of Service.
  8. On page 2 of the moonlighting waiver, complete the evaluation factors section. As you are completing the rest of the waiver, remember the following notes:    
    a. Question 3(a) needs to be answered if the physician checks False on Question 3.
    b. Question 7 and its sub-questions only apply to residents and fellows who will be practicing in an emergency room. Otherwise, you can leave these questions unanswered.
    c. The answer to Question 8 should be false. If a clinical extension site is providing malpractice liability coverage for the physician, submission of the moonlighting waiver is not required since CRICO coverage is not needed.
    d. If the resident or fellow is moonlighting outside of Massachusetts, they must have a license to practice in that state if the Board of Registration of Medicine requires it. If applicable, please complete Question 9.
    e. Question 10 must be answered with the name of the clinician who will be supervising the resident or fellow while moonlighting. If you are requesting multiple moonlighting locations, a supervising clinician is required for each location. If there is not enough space to write the names of all the applicable supervising clinicians, please include their names on a separate page or in your message when submitting the moonlighting waiver. Otherwise, CRICO Underwriting will follow-up with you for any missing names.
  9. Finally, be sure to have the resident or fellow and the Chief of Service sign the second page of the moonlighting waiver. Be sure also to include the printed name of the Chief of Service.
  10. Before submitting your waiver, please review the Moonlighting Coverage section of the Underwriting Manual to make sure that everything is correct. If you have access to the CRICO system, enter the moonlighting coverage and submit the moonlighting waiver to CRICO within 30 days. There are additional instructions on entering a moonlighting waiver into XMAPS on the website below the transcript of this video. If you do not have access to the CRICO system, you can submit the completed moonlighting waiver to CRICO Underwriting by emailing it to underwritingapps@rmf.harvard.edu or faxing it to (617) 450-8297.

February 22, 2018
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