Credentialing & Privileging

Ask the expert: What are the differences among managed care accrediting agencies regarding credentialing requirements?

Credentialing Resource Center Connection , March 5, 2009

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Although accrediting standards often change, there have been no recent significant differences between accreditation organizations regarding requirements for primary source verification. However, the NCQA does differ in its requirements regarding the timelines for credentials verification, which sometimes produces a difference in credentialing procedures. Specifically, the NCQA requires that the verification of some credentials be no older than 180 days at the time of final approval of the application. Thus, if processing a practitioner’s application is delayed, some of the verifications might expire during the delay.

This week’s question and answer are from the 2009 Credentials Verification Desk Reference, by Kathy Matzka, CPMSM, CPCS.



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