Recredentialing cycle tracking to NCQA 36-month standard

Steps

1. Record each provider's credentialing approval date as the start of their 36-month recredentialing cycle; NCQA requires recredentialing exactly every 36 months from the last approval date — not approximately every three years.
2. Set automated alerts at 120 days and 90 days before each provider's recredentialing due date to initiate the process with enough runway for primary source verification and committee review.
3. Complete all required primary source verifications (PSVs) within the timeframes required by 2025 NCQA standards: 120-day PSV window for Credentialing Accreditation, 90-day PSV window for Credentialing Certification.
4. Re-verify the same data elements required at initial credentialing: state licenses, DEA, board certifications, malpractice coverage, NPDB query, OIG LEIE, and SAM.gov checks.
5. Present the completed recredentialing file to the credentialing committee for a formal approval decision; document the decision date — this date resets the 36-month clock for the next cycle.
6. Track ongoing monitoring obligations between recredentialing cycles: per 2025 NCQA standards, license expiration and exclusion checks (OIG, SAM.gov) must be conducted monthly.