Submitting Entity (Participating Hospital) - I agree to electronically submit medical staff information to PHDB on those practitioners considered in good standing at my facility. I designate the PHDB as a primary source for such information for practitioners at our facility and agree to keep this information current on the PHDB. Because this information is submitted directly by my organization, I hereby indemnify and hold harmless the PHDB and WIN/Staff, Inc. from any and all liability and damages that may occur due to inaccurate submission of information by my organization. I agree that I have a signed release on file from subject practitioners to release PHDB-type of information to other healthcare organizations for the purpose of credentials evaluation. I agree that information we submit to the PHDB is made in good faith and without malice and is accurate to the best of our knowledge.
Querying Entity - I acknowledge that I am a healthcare organization or an authorized agent for a healthcare organization that is accessing the PHDB solely for the purpose of evaluating practitioners’ credentials and agree not to use such information for any other purpose. I acknowledge that I have a release on file from the practitioners that I query which includes his or her consent to obtain such information from primary sources such as PHDB for the purpose of evaluation of their credentials. I understand that all PHDB information is provided directly by hospitals and I will assume the responsibility to review all information printed on the verification letter. I hereby indemnify and hold harmless the PHDB and WIN/Staff, Inc. from any and all liability and damages due to inaccurate submission of information by the hospital and/or my failure to properly review the verification information. I also agree to hold harmless from liability the Participating Hospital(s) which I obtain verification letter(s) from the PHDB, its directors, officers, employees, and members of peer review committees for any statements or determinations made in good faith and without malice in response to requests for peer review information to be used at my healthcare organization in a credentialing process.
All Entities - I understand that there is a fee incurred for using the PHDB for primary source verification. The fee is payable either through a subscription (available to Participating Hospitals) or on a per query fee basis. For per query fee payment, I understand that my account will be billed once a month, either through a prepaid account or by credit card. I authorize WIN/Staff, Inc. to bill this account for verifications requested by my organization through the PHDB.