Which organization sets time limits for PSV verifications?

Which organization sets time limits for PSV verifications?

• A. JCAHO
• B. AMA
• C. NCQA
• D. CMS

Answer: (C)

Primary Source Verification relies on checking credentials directly with the issuing source (licensure boards, medical schools, residency programs, board certifications, malpractice histories, etc.) to confirm accuracy and current status. Timeliness matters because verifications that are too old may not reflect a provider’s current qualifications or licensure. The organization that sets the specific time limits for how recent PSV verifications must be is the National Committee for Quality Assurance (NCQA). NCQA’s credentialing standards define how fresh verifications need to be and require re-verification within defined windows at appointment and again at reappointment. This standardization helps ensure consistency across plans and providers and keeps credentialing decisions based on up-to-date information. Other organizations like the Joint Commission, AMA, or CMS play important roles in healthcare oversight, but the time-frame requirements for PSV are defined by NCQA.

Primary Source Verification relies on checking credentials directly with the issuing source (licensure boards, medical schools, residency programs, board certifications, malpractice histories, etc.) to confirm accuracy and current status. Timeliness matters because verifications that are too old may not reflect a provider’s current qualifications or licensure.

The organization that sets the specific time limits for how recent PSV verifications must be is the National Committee for Quality Assurance (NCQA). NCQA’s credentialing standards define how fresh verifications need to be and require re-verification within defined windows at appointment and again at reappointment. This standardization helps ensure consistency across plans and providers and keeps credentialing decisions based on up-to-date information. Other organizations like the Joint Commission, AMA, or CMS play important roles in healthcare oversight, but the time-frame requirements for PSV are defined by NCQA.