Which accreditation does not require credentialing in certain settings, such as inpatient setting for organizational member only, pharmacy benefits management, or locum tenens unless the assignment lasts more than 90 days?

Which accreditation does not require credentialing in certain settings, such as inpatient setting for organizational member only, pharmacy benefits management, or locum tenens unless the assignment lasts more than 90 days?

• A. URAC
• B. NCQA
• C. Ambulatory Care Facility (AAAHC)
• D. The Joint Commission

Answer: (B)

Credentialing rules in accreditation differ by setting and duration, and NCQA includes a practical exception for short-term or non-clinical roles. Under NCQA standards, certain arrangements such as involvement in inpatient activities for an organizational member only, work within pharmacy benefits management, or locum tenens assignments are not required to undergo full credentialing unless the assignment lasts longer than a defined period. This 90-day threshold recognizes that brief, non-direct-care involvement or temporary staffing does not create ongoing patient care affiliations that would necessitate separate credentialing processes. If the assignment exceeds that period, credentialing is then required to ensure clinicians meet all qualifications for ongoing care within the network. In contrast, other accrediting bodies typically require credentialing and privileging more uniformly for providers who will participate in patient care within their accredited settings, regardless of short duration, so they don’t offer the same short-term carve-out.

Credentialing rules in accreditation differ by setting and duration, and NCQA includes a practical exception for short-term or non-clinical roles. Under NCQA standards, certain arrangements such as involvement in inpatient activities for an organizational member only, work within pharmacy benefits management, or locum tenens assignments are not required to undergo full credentialing unless the assignment lasts longer than a defined period. This 90-day threshold recognizes that brief, non-direct-care involvement or temporary staffing does not create ongoing patient care affiliations that would necessitate separate credentialing processes. If the assignment exceeds that period, credentialing is then required to ensure clinicians meet all qualifications for ongoing care within the network.

In contrast, other accrediting bodies typically require credentialing and privileging more uniformly for providers who will participate in patient care within their accredited settings, regardless of short duration, so they don’t offer the same short-term carve-out.