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Core Standards

Written Policies and Procedures (CVO 1 Element A)
Protecting Credentialing Information (CVO 3 Element D)
Protecting Credentialing Information (CVO 3 Element E)

Certification Options

Verifying and Reporting Licensure (CVO 4)
Verifying and Reporting DEA or CDS Certification (CVO 5)
Verifying and Reporting Education and Training (CVO 6)
Verifying and Reporting Board Certification Status (CVO 7)
Verifying and Reporting Work History (CVO 8)
Verifying and Reporting Malpractice History (CVO 9)
Verifying and Reporting State Licensing Board Sanctions (CVO 10)
Verifying and Reporting Medicare/Medicaid Sanctions (CVO 11)
Processing Application and Attestation (CVO 12)
Application and Attestation Content (CVO 13)
Ongoing Monitoring of Sanctions (CVO 14)

2016 Standards & Guidelines

Core Standards

1. Written Policies and Procedures (CVO 1)

  • Does the organization have policies and procedures for verification, frequency of reporting and management of credentials data? 

2. Process for Internal Continuous Quality Improvement (CVO 2)

  •  Does the organization have a process for continuous quality improvement? 
  • Is a client complaint process in place? 

3. Protecting Credentialing Information (CVO 3)

  • Does the organization have policies and procedures regarding the confidentiality of credentialing information? 
  • Is a system for limiting physical access to credentialing information in place?  
  • Are password protection processes in place?  
  • Are data recovery and back-up processes in place? 

Certification Options

4. Verification of Licensure (CVO 4)

  • Does the organization use NCQA-approved sources to verify practitioner licensure? 

5. Verifying and Reporting DEA or CDS Certification (CVO 5)

  • Does the organization use NCQA-approved sources to verify practitioner DEA or CDS certification? 

6. Verifying and Reporting Education and Training (CVO 6)

  • Does the organization use NCQA-approved sources to verify practitioner education and training? 

7. Verifying and Reporting Board Certification Status (CVO 7)

  • Does the organization use NCQA-approved sources to verify practitioner board certification status?

8. Verifying and Reporting Work History (CVO 8)

  • Does the organization use NCQA-approved sources to verify practitioner work history? 

9. Verifying and Reporting Malpractice History (CVO 9)

  • Does the organization use NCQA-approved sources to verify practitioner malpractice claims history? 

10. Verifying and Reporting State Licensing Board Sanctions (CVO 10)

  • Does the organization use NCQA-approved sources to verify practitioner medical board sanctions? 

11. Verifying and Reporting Medicare/Medicaid Sanctions (CVO 11)

  • Does the organization use NCQA-approved sources to verify practitioner Medicare/Medicaid sanctions? 

12. Processing Application and Attestation (CVO 12)

  • Does the process applications according to NCQA requirements? 

13. Application and Attestation Content (CVO 13)

  • Does the organization’s application meet NCQA requirements? 

14. Ongoing Monitoring of Sanctions (CVO 14)

  • Does the organization have policies and procedures for ongoing monitoring of practitioner sanctions between recredentialing cycles?

15. Delegating CVO Activities (CVO 15)

  • If the organization delegates to a third party, is the responsibilities of the organization and delegated party—clearly documented? 
  • Does the organization evaluate and approve the delegated party’s plan on a regular basis?  


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