FAQ Directory: Credentials Verification Organization

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.

CVO 2016

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.

CVO 2016

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

CVO

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

CVO

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.

CVO

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

CVO

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.

CVO

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.

CVO

• 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.

CVO

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:

CVO 2016

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.

CVO

The organization and the CVO determine the documentation methods for reporting information. Acceptable methods include a checklist, the actual documents and access to electronic credentialing files. When an organization delegates to a certified CVO, NCQA reviews the organization’s credentialing files to assess timeliness and ascertain whether the credentialing decision was made within the specified time limits (i.e., 180 calendar days from verification).

CVO 2013