• Medical Board Sanctions
• Medicare/Medicaid Sanctions
• Ongoing Monitoring of Sanctions

• Is a quality assessment program that health care organizations can use to assess Credentials Verification Organizations and other organizations that verify the credentials of physicians.
• Evaluates a CVO's management of various aspects of its data collection and verification operation, and the process it uses to continuously improve the services it provides.
• Reduces duplicative oversight and inefficient gathering of information by health plans and CVOs.
• Includes rigorous on-site evaluations conducted by a team of health care professionals and certified credential specialists. A national oversight committee of physicians analyzes the team’s finding and determines certification based on the CVO’s compliance with NCQA standards.
• Is governed by NCQA's rigorous Standards for Certification, developed with the assistance of representatives from the credentials verification industry, as well as input from managed care organizations.

NCQA is an independent, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans, managed behavioral healthcare organizations, preferred provider organizations, new health plans, physician organizations, credentials verification organizations, disease management programs and other health-related programs.

NCQA's mission is to improve the quality of health care.

• URAC, an independent, nonprofit organization, is a leader in promoting health care quality through accreditation and certification programs.
• URAC's standards keep pace with the rapid changes in the health care system, and provide a mark of distinction for health care organizations to demonstrate their commitment to quality and accountability.
• Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in setting meaningful standards for the health care industry.

• The applicant must supply information on accessibility, education and training, work history, state licensure or certification, liability insurance information, liability claims history, a history of adverse actions taken against the applicant and a release of information waiver.
• If the CVO conducts reviews of practitioner offices, it must use health care practitioners to conduct the onsite review. The review of the office must look at patient access, public health policies and procedures and safety standards for fire, emergency and equipment maintenance.
• The CVO must have a written quality improvement plan that includes evidence of routine inspections of data and databases, annual random sampling of staff activities and improvements in areas of concern.