Customer Success Story: How Verifiable Helps Organizations Modernize Credentialing Processes to Meet NCQA Standards
October 8, 2025 · Becky Kolinski
Efficient credentialing processes can help improve access to health care and protect patient safety. Everyone has a stake in the process: Health plans want to maximize network coverage, care delivery organizations need to get clinicians into networks quickly so they can start seeing patients, credentialing vendors want to provide timely, accurate services that comply with NCQA standards.
Verifiable is an NCQA-certified credentials verification organization (CVO) and software provider that supports health care organizations with large-scale credentialing operations, automated compliance monitoring and easier enrollment and licensing management.
“The purpose of credentialing—to keep patients safe and to make sure organizations remain compliant—has not changed,” says Janan Dave, Vice President of Operations at Verifiable. “But the technology enabling the process should change, so organizations can operate more efficiently at scale.”
Automation Drives Efficiency
“If you walked into a credentialing department 25 years ago, you would see file cabinets filled with manilla folders and paper,” says Dave. “Some organizations still do it that way.”
Verifiable partners with CVOs, health plans and care delivery organizations that perform credentialing in-house, to help them transition from manual and low-tech credentialing processes to automated ones. Verifiable’s customers share four common goals:
- Make credentialing processes more efficient, and reduce manual efforts.
- Grow provider networks, and scale operations without inflated headcount.
- Reduce turnaround times and uphold data collection requirements to meet NCQA’s credentialing standards.
- Create a single source of truth for self-serve insights to improve data quality and accuracy.
While efficiency is important, credentialing is also about compliance and managing the ever-present risk of sanctioned and excluded providers. “If you’re still tracking sanctions and exclusions manually, chances are, you’re going to miss something,” says Dave. “Credentialing automation can help organizations reduce risk.”
Modernizing Credentialing Processes
Verifiable has an array of solutions to help organizations meet NCQA standards—whether they perform credentialing internally, delegate it to Verifiable’s NCQA-certified CVO, or both:
- Credentialing software for organizations performing credentialing in-house or using a hybrid model of in-house and delegated services.
- CVO services for delegated credentialing arrangements.
- Provider network monitoring for sanctions and exclusions.
“Credentialing is not a one size fits all approach—organizations need flexibility based on their size, resources and strategic priorities,” says Dave. “Smaller teams and startups may prefer a sub-delegated CVO arrangement, while organizations with established processes may benefit from a hybrid or in-house model as they pursue Accreditation enabled by Verifiable’s technology.”
Benefits of NCQA Credentialing Certification
Verifiable decided to pursue NCQA Credentialing Certification to demonstrate the value of its products and services. Because credentialing is a compliance-driven process, vendors are highly scrutinized by potential customers—many are mandated by state law or contract to work with Accredited or Certified vendors.
“NCQA is the gold standard in the market when it comes to credentialing,” says Dave. “Achieving NCQA Credentialing Certification shows our organization’s commitment to compliance and reliability.”
Benefits of NCQA Credentialing Certification include:
- Demonstration of Verifiable’s commitment to providing high-quality services.
- Building trust with prospective clients.
- Reducing the audit burden for Verifiable and its customers.
- Making it easier to meet state regulatory requirements for health plans operating in states that mandate NCQA Health Plan Accreditation.
“NCQA Certification has unlocked conversations with prospective customers,” says Dave. “Organizations are hesitant to work with a vendor that hasn’t been evaluated by a respected, independent accrediting body like NCQA.”
Preparing Customers for Success
In 2024, NCQA updated its credentialing standards to reflect the modern approaches and digital verifications organizations are adopting. Verifiable used resources provided by NCQA to make sure its software and workflows remain compliant. Some best practices:
- Purchase and review new standards as soon as they are available.
- Review NCQA materials regarding changes to credentialing standards—especially when proposed changes are released for public comment.
- Check frequently asked questions on NCQA’s website a few times a month for additional guidance.
- Submit questions about the standards via My NCQA. “Responses are always timely, thoughtful and informative,” says Dave.
Verifiable also helps educate customers about changes to credentialing standards by creating easily digestible content, such as What You Need to Know About NCQA Credentialing Standards in 2025 and Beyond.
“We’re proud to have earned the NCQA seal for our credentialing services,” says Dave. “NCQA Certification gives our customers confidence that we will meet or exceed the required standards and time frames.”
Learn More
Learn more about Credentialing Accreditation and Certification.
Purchase a copy of the standards in the NCQA Store.
If you’re attending the 2025 Health Innovation Summit, October 13–15, in San Diego, CA, sign up for the pre-conference workshop, Uncovering Delegation’s Value for Your Organization.
