The National Committee for Quality Assurance is taking applications for a new round of certification surveys covering services that verify physician credentials on behalf of managed-care organizations.
This time, the Washington-based accreditation and evaluation agency will open up the eligibility for certification to verification services operated by provider groups, medical societies and managed-care organizations themselves. The certification program, begun in October 1995, originally focused on stand-alone credential-verification businesses.
Verification of physician credentials, such as medical school diploma, board certification and malpractice history, is a key component of NCQA accreditation. Before the NCQA's certification effort was established, the policies of such verification businesses had to be reviewed and approved by each of the health plans under contract.
Certification will stand as sufficient evidence for NCQA accreditors and eliminate the need for each plan to cover the same ground. The NCQA said many managed-care organizations delegate responsibility for verification of credentials to such businesses.
The two-day survey process includes an on-site review of the organization's policies and procedures as well as a review of its mechanisms to maintain the integrity and confidentiality of credentials and to monitor physician disciplinary actions.
Organizations newly eligible for certification include medical groups and independent practice associations offering credential verification services as well as the corporate credentialing programs established by large managed-care organizations, the NCQA said.
Applications are due Aug. 16 and can be obtained by phoning 202-955-5697. The surveys will be performed between Sept. 21 and Dec. 31. Another application period is planned for early in 1997.
In the first round of surveys, 26 organizations were reviewed, and the results will be available in September.