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Joint Commission: Ensure that information from CVOs is complete, accurate, and timely

Credentialing & Verification Update, September 26, 2007

Hospitals use credentialing verification organizations (CVO) for numerous credentialing activities, including distributing and receiving applications, conducting primary source verification, collecting letters of reference, querying the National Practitioner Data Bank (NPDB) as an agent of the hospital, and verifying clinical experience.

Every hospital that uses a credentials verification organization should note that the hospital still bears the ultimate responsibility for the entire credentialing process and its outcome. Therefore, a hospital should monitor a CVO's activities to ensure that it follows all policies and procedures.

The Joint Commission states that hospitals that use information from a CVO should be confident that the data they receive is complete, accurate, and timely. The Joint Commission also outlines principles to initially and periodically evaluate a CVO with regard to the following aspects:

• What data are available from the CVO
• How the CVO collects data, how the information is developed, and what verification processes are used
• Information on the CVO's database functions including limitations on the information available (e.g., practitioners who are not in the database); turnaround time for reporting; and a summary of quality control processes including transmission accuracy, data integrity, data security, and technical specifications
• The method by which the information will be transmitted from CVO to the hospital
• Specification of what information is obtained from the primary source versus a secondary source
• Whether time-sensitive data are collected and verified (e.g., licensure) and whether information on expiration dates is provided, as well as the date on which the information was last updated
• A certification that the information transmitted to the hospital reflects the information the CVO obtained
• Whether the information obtained is complete or if there is additional information available (and, if so, where to obtain it)
• The mechanisms available through the quality control system to resolve issues regarding transmission errors, inconsistencies, or other data concerns

The Joint Commission also states that hospitals should have a formal arrangement with the CVO for communication regarding changes in credentialing information.

Searching for CVO? If your healthcare organization is considering outsourcing its credentialing activities to a CVO, start your search with CPDR. If you subscribe to CPDR, you have access to a list of CVOs online. Not yet a CPDR subscriber? CVU invites you to sign up for a free 30-day trial. To sign up, click here.

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