OUTPATIENT ORAL MAXILLOFACIAL

How to become accredited and maintain accreditation in our Outpatient Oral Maxillofacial Program

Accredited oral maxillofacial facilities must meet standards written for the delivery of safe oral surgery care requiring unique anesthesia delivery and disinfection practices. This program is designed to ensure optimal patient safety while meeting the specific needs of the oral surgery community.

Accreditation Process for Outpatient Oral Maxillofacial

 

New Applicants

Below is a list of documentation that must be completed for the Outpatient Oral Maxillofacial Application. Please mail completed documentation to AAAASF at 7500 Grand Ave, Suite 200, Gurnee, IL 60031 or fax to 847-775-1985. You may also scan and email to reception@aaaasf.org.

  • Application Form with payment
  • Floor plan for facility
  • A copy of each physician’s State Medical License
  • A copy of each physician’s Board Certificate or letter of admissibility by the physician/surgeon certifying board (ABMS or ABOMS)
  • A current copy of the delineation of hospital privileges for each physician/surgeon (must state the department of Surgical Specialty and list the procedures that may be performed at the hospital)
  • Authorization to Release Information Form signed by each physician on staff
  • HIPAA Business Associate Agreement
  • Facility Identification Form
  • Staff Identification Form
  • Facility Director’s Attestation Form
  • Random Review Form
  • Unanticipated Sequela Form
  • New York OBS Addendum (NEW YORK APPLICANTS ONLY)
  • Appropriate legal documentation as specified under your entity type on the New York OBS Addendum (NEW YORK APPLICANTS ONLY)

Once the documentation is received in the AAAASF office it will be reviewed within 10 business days and you will be contacted if additional paperwork is needed.

Please review the Standards and Checklist Manual carefully before submitting the completed documentation to AAAASF.

Download Documents

Self Survey – Before 2nd & 3rd Years Begin

Below is a list of documentation that must be completed for the Outpatient Oral Maxillofacial Self Survey. Please mail completed documentation to AAAASF at 7500 Grand Ave, Suite 200, Gurnee, IL 60031 or fax to 847-775-1985. You may also scan and email to reception@aaaasf.org.

  • Facility Identification Form
  • Staff Identification Form
  • Facility Director Attestation Form
  • Completed Standards Manual

If deficiencies are found, a report will be sent to the facility director allowing 30 days for correction. Otherwise, once the documentation is processed, a new certificate will be mailed out to the facility at no cost.

Please review the Standards and Checklist Manual carefully before submitting the completed documentation to AAAASF.

Download Documents

Re-Survey – Before End of 3 Year Cycle

Below is a list of documentation that must be completed for the Outpatient Oral Maxillofacial Re-Survey. Please mail completed documentation to AAAASF at 7500 Grand Ave, Suite 200, Gurnee, IL 60031 or fax to 847-775-1985. You may also scan and email to reception@aaaasf.org.

  • A copy of each physician’s State Medical License
  • A copy of each physician’s Board Certificate or letter of admissibility by the physician/surgeon certifying board (ABMS or ABOMS)
  • A current copy of the delineation of hospital privileges for each physician (must state the department of Surgical Specialty and list the procedures that may be performed at the hospital)
  • Authorization to Release Information form signed by each physician on staff
  • Facility Identification Form
  • Staff Identification Form
  • Facility Director’s Attestation Form
  • New York OBS Addendum (NEW YORK OBS FACILITIES ONLY)
  • Copy of Floor Plan

Once all of the required documentation is received in the AAAASF office, it will be reviewed within 10 business days. You will be contacted if additional paperwork is needed. Otherwise, you will receive a request to submit your facility’s hours of operation and blackout dates so that a survey can be scheduled. An email confirmation will be sent to you once the survey has been arranged.

Please review the Standards and Checklist Manual carefully before submitting the completed documentation to AAAASF.

Download Documents