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Credentials Verification Organization (CVO) Certification


NCQA’s Credentials Verification Organization (CVO) Certification Program evaluates credentials verification operations and the processes that the CVO uses to continuously improve the services it provides to its managed care clients.  CVO certification is available to organizations that conduct credentials verification, report the credentialing information to clients and have systems in place to protect the confidentiality and integrity of the information. 

The NCQA Certification Survey includes rigorous onsite and offsite evaluations conducted by a survey team that includes at least one CR surveyor and one administrative surveyor.  A Review Oversight Committee (ROC) of physicians analyzes the team's findings and assigns a certification status based on the CVO's performance against core standards and the requirements within applicable certification options.

What Certification Levels Can a CVO Achieve? 

CVOs can earn the following NCQA Certification status levels based on their performance against NCQA's Standards and Guidelines: 

Certification: NCQA awards certification to an organization that demonstrates, in NCQA’s judgment, substantial performance against the requirements within the core standards and the chosen certification options. 

Denial of Certification: A denied status occurs when, in NCQA’s judgment, the organization fails significantly to comply with the requirements within the core standards and the chosen certification options of the CVO program.

CVO Certification Resources

New Online Application Process

A new application and scheduling process begins May 15 for Accreditation programs.


Learn more

NCQA Survey Systems

Prepare for your survey (ISS)
Login to ISS to prepare for and submit your Survey Tool for survey. 

Review a submitted survey (IRT)
Login to ISS to prepare for and submit your Survey Tool for survey. 

More information on IRT
Learn more about NCQA’s Interactive Review Tool, including training information.

NCQA Policy Support

Policy Updates

Corrections, clarifications and policy changes to our stated Standards and Guidelines 

FAQs
New FAQs are posted on the 15th of every month and provide answers to our most commonly asked questions. 

Policy Clarification Support (PCS)
If you cannot find an answer to your question in our FAQs or Policy Updates, submit your inquiry here

CVO Report Card

View the Credentials Verification Organization Certification Report Card.


View Report Card

HEDIS Users Group (HUG)
HUG membership packages offer you access to the most up-to-date information on HEDIS specifications so you can begin planning for the future.

HEDIS and ICD-10
To accommodate the switch from ICD-9-CM to ICD-10, NCQA created a plan to identify a valid and appropriate set of ICD-10 codes for each HEDIS measure.

 

CVO Certification Resources