Credentials

• 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.