fbpx

Credentials Verification Organization Certification Requirements

NCQA Credentials Verification Organization (CVO) Certification evaluates organizations performing credentials verification services. Your organization must meet the eligibility criteria to pursue the certification.

FOCUS AREAS TO ENSURE HIGH QUALITY

NCQA CVO Certification is designed to ensure that organizations can maintain a high-quality network for members and contracted clients. Requirements cover these key areas:

  • An internal QI process.
  • Protecting credentialing information.
  • Verifying credentials.

To see all program requirements, get the Standards & Guidelines document.

REQUIRED ORGANIZATION SERVICES

The standards are designed for organizations that focus on credentials verification services, including verification of practitioner credentials through a primary source, through a recognized source or through a contracted agent of the primary source.

IS MY ORGANIZATION ELIGIBILE?

Any organization that provides credentials verification services can apply for Certification if it:

  • Verifies practitioner credentials for health plans, MBHOs, physician organizations or health care organizations, and
  • Provides verification services for at least six months before application, and
  • Performs verification activities for at least 50% of contracted practitioners, and
  • Maintains the necessary credentials documentation, policies and procedures for NCQA to conduct the survey, and
  • Obtains errors and omissions insurance for $1M–$2M.
  • Save

    Save your favorite pages and receive notifications whenever they’re updated.

    You will be prompted to log in to your NCQA account.

  • Email

    Share this page with a friend or colleague by Email.

    We do not share your information with third parties.

  • Print

    Print this page.