Lengthy checklists representing the time-consuming process of primary source verification.

Primary Source Verification

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CredentialingOne Blog

Primary Source Verification

Posted on Friday, April 17, 2020

What is Primary Source Verification?

Primary source verification (PSV) is the process of validating a provider’s credentials through direct contact with the person or organization that actually issued the information.

Lengthy checklists representing the time-consuming process of primary source verification.

CredentialingOne can complete the time-consuming PSV process for you.

According to The Joint Commission, PSV is:

“Verification of an individual practitioner’s reported qualifications by the original source or an approved agent of that source. Methods for conducting primary source verification of credentials include direct correspondence, documented telephone verification, secure electronic verification from the original qualification source, or reports from credentials verification organizations (CVOs) that meet Joint Commission requirements.”

PSV requires detailed documentation, which should include:
  • Date the PSV was conducted
  • Method of verification (e.g. letter, fax, email, phone, website)
  • Agency and/or individual person contacted for verification and their contact information
  • The information that was specifically verified
  • Results of the PSV (e.g. questions asked and their answers)
  • Person who conducted the PSV and their signature

Why is Primary Source Verification Necessary?

Primary source verification is vital to accurate and credible credentialing. It is simply inadequate to accept information submitted by a provider or document photocopies at face value.

PSV protects your patients’ safety by helping to ensure your practitioners are qualified to care for them. Furthermore, it protects your organization from legal risks and compliance issues.

PSV is the standard form of verification for the healthcare industry and helps healthcare facilities meet the accreditation requirements of The Joint Commission and NCQA.

Primary Sources Vs. Secondary Sources

The Joint Commission has deemed some entities “designated equivalent sources,” meaning it considers them to provide information identical to that provided by the original source. Your options for PSV are contacting the original source or any designated equivalent sources.

You should only use secondary sources to verify credentials in cases where it is truly not possible to contact the original source (such as when the issuing agency or hospital has closed) and designated equivalent sources are unable to verify the information. For example, if an establishment is no longer in operation you may try contacting any successor organizations or find out where original documents may have been sent.

Primary Source Verification Services

PSV is a very involved and time-consuming process that entails manual, repetitive tasks that must be completed for EACH credential and for EVERY provider. Some designated equivalent sources also require payment to gain access.

Fortunately, CredentialingOne can contact/access each of these sources (original sources and/or designated equivalent sources) for you as well as document the completion of PSV for each of your providers’ credentials. We also monitor providers’ compliance, so you don’t have to manually track credentials and documentation and can ensure they’re renewed before they expire.

For more information on primary source verification and how CredentialingOne can help, contact us today.


By Stephanie Salmich

An emergency sign outside a hospital is shown, along with the blog title: COVID-19 Resources for Provider Privileging During a National Health Emergency.

COVID-19: Resources for Provider Privileging During a National Health Emergency

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CredentialingOne Blog

COVID-19: Resources for Provider Privileging During a

National Health Emergency

Posted on Monday, March 30, 2020

An infographic outlining different providers hospitals may call upon to help during the coronavirus crisis, which notes that many regulations are temporarily changed for provider privileging during a national health emergency.During a national health emergency such as that caused by the coronavirus, many facilities experience a provider shortage.

To combat COVID-19, you may need to expand your team of healthcare professionals by relying more heavily upon retired and volunteer providers, part-time clinicians, practitioners from other states, practitioners from other departments, and telehealth.

Provider Privileging During a National Health Emergency

During a health crisis, hospitals strive to grant privileges to these clinicians as quickly as possible while still protecting patients by providing them with qualified practitioners.

The federal and state governments, along with other regulatory entities, are temporarily adjusting some licensing and privileging requirements to accommodate the greater need for more providers and access to care due to COVID-19.

CredentialingOne can help you navigate any new and/or temporary rules and ensure your patients receive safe care from competent providers.


To start, we’ve compiled a list of resources to consult regarding provider privileging during a national health emergency:


An emergency sign outside a hospital is shown, along with the blog title: COVID-19 Resources for Provider Privileging During a National Health Emergency.

Many regulations are temporarily changed for provider privileging during a national health emergency.

1135 Waivers – the U.S. Department of Health & Human Services (HHS) is authorized to issue waivers during the COVID-19 national emergency. You can find information on blanket waivers and how to apply for individual waivers here. You must send individual waiver requests to your CMS Regional Office, and office email addresses can be found here.

Disaster PrivilegesThe Joint Commission has posted requirements for privileging, re-privileging/re-appointment, and telehealth privileging during a disaster.

Medicare Provider Enrollment – the Centers for Medicare & Medicaid Services (CMS) is offering new flexibilities regarding Medicare provider enrollment, including waiving certain screening requirements, allowing licensed providers to perform services outside their state of enrollment, and expediting applications; see its FAQs.

Medicare Telehealth CMS has expanded Medicare telehealth to include a wider scope of services so that more patients can access care from home; see its FAQs and Fact Sheet.

States Waiving Licensure Requirements/Renewals – the Federation of State Medical Boards (FSMB) created this table along with links to the original sources declaring the changes in response to the coronavirus.

States Expediting Licensure for Inactive/Retired Licensees – the FSMB created this table, which includes links to states’ resource pages.

The Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP) this program verifies registered healthcare volunteers’ credentials in advance, so they can respond more quickly to help in a crisis. (Hospitals should check with their insurance companies to determine how volunteer providers may/may not be covered by their malpractice insurance.)

For additional information, you can also contact your specific state medical association.


These resources may be updated as the COVID-19 situation progresses.

If you need further guidance on provider privileging during a national health emergency, please contact us – we’re here to help.


By Stephanie Salmich

An annual health plan audit is performed.

Why an Annual Health Plan Audit is Critical to Your Success

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CredentialingOne Blog

Why an Annual Health Plan Audit is Critical to Your Success

Posted on Tuesday, December 3, 2019

Conducting an annual health plan audit is critical to the success of your practice. Over the life of a practice, providers and staff come and go and insurance companies add and terminate health plans. Keeping track of these changes is key to protecting your practice from legal issues and ensuring adequate cash flow.

Protecting Your Practice

When a new provider joins a practice, they must of course become credentialed and linked to the practice’s payor contracts in order to be considered “in-network.” However, most practices forget that they must notify their payors when a provider leaves their practice as well.

Payor contracts include language requiring a practice to send notification within a specific time frame when a provider terminates. Not only does notification of the termination date keep the practice compliant with these contracts, but it also protects the practice if the provider experiences malpractice issues or sanctions after leaving the practice.

Performing a health plan audit can ensure all payors are up to date on the providers currently associated with your practice.

Improving Front Desk Collections

A health plan audit is also crucial for front desk collections.

Turnover of front desk staff is not uncommon for any practice. It is vital that both your new and experienced staff members know the plans in which each provider participates. They also must be knowledgeable about the payors with whom your practice holds contracts.

Without a current roster of plan participation, the front desk will not know the appropriate co-pay or deductible to collect and your cash flow will bear the consequences.

An annual health plan audit is performed.

An annual health plan audit helps your practice maintain compliance and improves cash flow.


CredentialingOne’s maintenance and compliance services include an annual health plan audit. We can also provide health plan audit services on a standalone basis for clients.

The health plan audit process usually takes fewer than 30 days to complete.

Contact us today to learn more about how an annual health plan audit can protect both your practice’s liability and cash flow.


By CredentialingOne