NCQA HP 2015 Posted on February 15,2015
Use of credentialing and recredentialing verification to meet factor 3
General Content Area: QI - Quality Management and Improvement
Tag: QI 12A
For QI 12, Element A, factor 3, do verification activities conducted during the initial credentialing and recredentialing process count as quality measures?
CR 3–CR 6, credentialing verification activities do not count as quality measures for QI 12, Elements A and B. However, an organization may receive credit if its credentialing process incorporates clinical quality measures from NCQA (or other accreditors), the National Quality Forum (NQF), national medical boards (ABMS or AOA) or other quality measurement development sources. The organization may also incorporate member experience and cost-related measures into the credentialing process.