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NAMSS: Best Practices in Credentialing

Recently, the National Association of Medical Staff Services (NAMSS) published best practice standards for clinical practitioner credentialing related to all healthcare delivery settings charged with facilitation of a credentialing program.  One of the largest opportunities identified by NAMSS was industry-wide standardization of primary source verifications.

Whenever possible, organizations should make it a priority to verify all elements reported on the credentialing application with the primary, issuing source (‘primary source verification’).  In the event primary source verification is not possible, acceptable secondary sources may be used to verify the information.  However, approved secondary sources vary by accrediting organization and state regulation.  All information to support the following credentialing criteria should be less than one hundred and eighty (180) days old at the time of the credentials application review and approval:

Credentialing Element1

  • Proof of Identity
  • Education and Training
  • Military Service
  • Professional Licensure
  • DEA/CDS/State DPS Certification
  • Board Certification
  • Affiliations and Work History
  • Criminal Background and Disclosure
  • Sanctions Disclosure
  • Health Status
  • NPDB
  • Professional Liability
  • Professional and Peer References

Primary Source1

  • Government-issued identification
  • May include, but should not be limited to state regulation and application professional and training schools or residency training programs, National Student Clearinghouse, AMA, AOA, ECFMG, FSMB, and state medical boards
  • DD214, National Personal Records Center (NPRC), verification from the applicable military branch, and current duty station
  • State licensing boards and FSMB
  • DEA, National Technical Information Service (NTIS), state DPS, state CDS
  • Directly from the board of display agent, such as ABMS, AMA, ABPS or AOA
  • Verification from applicable facilities
  • National, state, and county criminal databases (facility-approved government body vendor)
  • Application attestation, practitioner’s application; physician, if applicable
  • National Practitioner Data Bank
  • Current and past malpractice carriers, NPDB
  • Letter or form signed and dated from the professional reference

1 http://www.namss.org/Portals/0/Regulatory/NAMSS%20Ideal%20Credentialing%20Standards%20Report%202017%20Update.pdf  Accessed 2/1/2019.