The Importance of NCQA Certification for CVOs Verifying credentials for practitioners and affiliated organizations is a key component of patient safety in healthcare. To perform thorough, efficient,...
No Easy Job
Credentialing and recredentialing providers is a complex process for health plans, hospitals and health systems, and state Medicaid agencies. Here’s why:
- Physicians are licensed in multiple states and provide telehealth services across state lines. This requires license verification with each state board and compliance to that state’s unique regulations.
- Identity matching is complicated due to physicians having the same name, maiden names, alias names, nicknames, or abbreviated names.
- To get a complete view, each physician must be screened, and credentials verified against thousands of primary sources.