Credentials Verification Organization Frequently Asked Questions

What is CVO Certification?

NCQA CVO Certification evaluates the operations of organizations that verify practitioner credentials. Verification is accomplished through the primary source, through a recognized source or through a contracted agent of the primary source.

How does Certification help my organization?

NCQA CVO Certification is designed to ensure organizations can maintain a high-quality network for members and contracted clients. The standards provide a framework for adopting industry best practices to promote accurate and efficient verification of practitioner credentials—ensuring that medical organizations employ qualified professionals and align with state requirements.

What are the Certification requirements?

CVO Certification assesses an organization’s performance in the following requirement areas:

• Internal Quality Improvement Process
• Protecting Credentialing Information
• Verifying credentials

NCQA’s CVO Certification program offers the following 11 certification options:

Where can I find the Standards and Guidelines?

The Standards and Guidelines document can be found in the NCQA Store.

What organizations are eligible for CVO Certification?

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.

What is the process for earning Certification?

The first step in earning Certification begins with an overview discussion with an NCQA program expert. Next, you will purchase the program resources, review, conduct a gap analysis and then submit your online application. Next you will align your processes with the standards. Finally, NCQA conducts the survey, creates a report and your Certification status is determined within 30 days of the final review. See a step-by-step process.

What is the price for CVO Certification?

Pricing is based on multiple factors. Full pricing information can be obtained by submitting a request through My NCQA.

How long will it take to earn Certification?

The typical evaluation timeframe, from application submission to decision, is 12 months. This depends on the organization’s readiness, as some organizations may already be working within NCQA guidelines.

How do I get started?

If you are not currently certified and are interested in learning more, contact NCQA. If you are currently Certified and want to talk to someone about your current status, renewing or adding Certifications, submit a question through My NCQA.

What information will help me get started?

• Certification Process and Timeline: identifies key steps, timing and resources to successfully seek Certification.
• Standards and Guidelines: provides the comprehensive descriptions of the standards, including the intent and the scope of review.
• Interactive Survey Tool: includes the complete standards and guidelines and allows your organization to determine its readiness for a survey by responding to each standard. The tool calculates your survey score.

What organizations have earned CVO Certification?

More than 90 organizations have earned CVO Certification. A directory of Certified organizations can be found at the NCQA Report Card.