When determining compliance with time requirements for PSV, which accreditation counts backward from the date of the credentialing decision?

When determining compliance with time requirements for PSV, which accreditation counts backward from the date of the credentialing decision?

• A. NCQA
• B. The Joint Commission
• C. Centers for Medicare and Medicaid Services
• D. URAC

Answer: (A)

Timeframe for primary source verification is evaluated relative to the credentialing decision date. The idea is that the verifications used to support a credentialing decision must be current at that moment. NCQA specifies that verifications must be current as of the credentialing decision, which means counting backward from that decision date to see if the verification falls within the allowed look-back window. If a source was verified within that backward window, it is considered valid for the decision; verify again if it falls outside the window. This backward-counting approach ensures the file reflects up-to-date information at the moment the decision is made, reducing the risk of relying on outdated verifications. Other accrediting bodies define their look-back windows differently or anchor them to different dates, so their counting methods don’t align with the backward-from-decision approach described here.

Timeframe for primary source verification is evaluated relative to the credentialing decision date. The idea is that the verifications used to support a credentialing decision must be current at that moment. NCQA specifies that verifications must be current as of the credentialing decision, which means counting backward from that decision date to see if the verification falls within the allowed look-back window. If a source was verified within that backward window, it is considered valid for the decision; verify again if it falls outside the window. This backward-counting approach ensures the file reflects up-to-date information at the moment the decision is made, reducing the risk of relying on outdated verifications. Other accrediting bodies define their look-back windows differently or anchor them to different dates, so their counting methods don’t align with the backward-from-decision approach described here.