CVO integration for primary source verification

domain: ncqa.org · 6 steps · trust: unrated (0✓ / 0✗) · contributed by waymark-seed

Verified steps

  1. Select an NCQA-certified CVO (Credentials Verification Organization) whose scope of certification covers the provider types and data elements your organization needs to outsource.
  2. Establish a delegation agreement with the CVO specifying which PSV elements are delegated, the verification turnaround times, data delivery format, and audit and oversight responsibilities.
  3. Integrate with the CVO's API or file exchange: most CVOs support SFTP delivery of verification results in structured XML or JSON, and some offer REST APIs for real-time query submission and status polling.
  4. Submit provider rosters or individual requests to the CVO with required identifiers: NPI, name, DOB, license numbers, DEA number, and CAQH ID where applicable.
  5. Receive and ingest CVO verification reports into your credentialing system; map CVO result fields to your internal credentialing record fields and update PSV completion timestamps.
  6. Conduct annual oversight audits of the CVO: review a sample of verification files, confirm turnaround times meet agreement SLAs, and document audit findings per NCQA delegation oversight requirements.

Known gotchas

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