Accelerate Provider Credentialing
NCQA Credentialing Accreditation helps provider organizations, CVOs, and health systems reduce administrative burden, improve data integrity, and meet payer expectations.
Learn how NCQA’s Credentialing Accreditation program provides a framework that ensures a consistent, effective and diligent credentialing process.
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A Quality Improvement Framework for Credentialing
Credentialing is a critical safeguard in health care, ensuring organizations verify the qualifications and legitimacy of licensed medical professionals. NCQA Credentialing programs provide a structured framework to:
- Reduce credentialing cycle times and get providers enrolled faster
- Meet payer and delegation requirements with confidence
- Ensure data accuracy, security, and compliance
- Demonstrate commitment to quality and continuous improvement
Two Tailored Program Options
Recognizing that credentialing responsibilities differ by organization, NCQA offers two tailored program options
NCQA Credentialing Accreditation
Designed for organizations that perform full‑scope credentialing. This includes primary source verification and credentialing/recredentialing committee review and decision‑making for practitioners.
NCQA Credentialing Certification
Designed for organizations that verify practitioner credentials only. Verification is completed through primary sources, recognized sources, or approved contracted agents, without committee review.
| Credentialing Challenges | How NCQA Solves Them |
|---|---|
| Manual, time‑consuming verification processes | Standardized, rigorous credentialing requirements |
| Inconsistent data and audit risk | Clear framework for compliance and continuous improvement |
| Delays in provider enrollment and revenue start | Recognition that health plans trust and prefer |
| Difficulty meeting payer and delegation expectations | Reduced rework and administrative burden |
Comprehensive Guide
Download A Comprehensive Guide to NCQA Credentialing Programs
NCQA Credentialing Accreditation can help your organization improve its credentialing/recredentialing processes—and our newest eBook, A Comprehensive Guide to NCQA Credentialing Programs, contains the information you need to begin.
Ready to Strengthen Your Credentialing Process?
We’re there with you every step of the way.
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