CVO / Delegation (NAMSS Comparison)

Question 1

CVOs / DELEGATION: This accreditation states that organizations that use information from a CVO should have confidence in the completeness, accuracy, and timeliness of that information and outlines ten principles to evaluate such an agency. Among the necessary aspects are disclosure of data and information available, processed utilized, database functions, format for transmitting practitioner information, identification of primary source information versus information obtained from a secondary source, date information was last updated by the primary source, accuracy of data provided, availability of additional information from the primary source, overview of quality control measures related to data integrity, and how the CVO communicates changes in credentialing information

a. AAAHC
b. NCQA
c. TJC (CAMH)

Answer 1

TJC (CAMH)

Question 2

CVOs / DELEGATION: CR 8 Element A Factor 1 - 6 CVOs are allowed to be used and credentialing policies and procedures include the process used to delegate credentialing and recredentialing, can be delegated, how the decision to delegate is made. The organization maintains the right to approve, suspend, or terminate practitioners and has responsibility for oversight of the delegated agency. There must be a mutually agreed upon document describing each organizations’ responsibilities, including credentialing system controls, the delegated activities, the process for evaluation and outcome if obligations are not fulfilled. There must be, at least, semi-annual reporting by the delegated entity to the organization. If the CVO achieves NCQA certification for all delegated credentialing elements, this oversight responsibility is waived.

a. URAC
b. ACHC (HFAP)
c. NCQA

Answer 2

NCQA

Question 3

CVOs / DELEGATION: A professional credentialing organization, such as a CVO can be used to perform PSV, but the process for credentialing by the organization must reflect the requirements as stated in the standards.

a. ACHC (HFAP)
b. AAAHC
c. TJC (CAMH)

Answer 3

ACHC (HFAP)

Question 4

CVOs / DELEGATION: MS 15 Interpretive Guidelines read that while hospitals may use third-party credentialing verification organizations to compile and verify the credentials of practitioners applying for privileges, the hospital’s governing body is still legally responsible for all privileging decisions.

a. DNV (NIAHO)
b. AAAHC
c. Medicare CoP

Answer 4

DNV (NIAHO)

Question 5

CVOs / DELEGATION: The organization can delegated credentialing. If it does, it must establish and implement criteria and assessment processes prior to delegation of functions, including a process to conduct a review of the potential contractor’s written policies and documented procedures and capacity to perform delegated functions. There must be a written contract

a. URAC
b. NCQA
c. ACHC (HFAP)

Answer 5

URAC

Question 6

CVOs / DELEGATION: CVO is allowed. The organization must perform an assessment of the capability and quality of the CVO’s work. Accreditation or certification of the CVO by a nationally recognized organization can meet this requirement. If the organization uses a CVO or another organization to verify credentials, those entities must perform primary source verification unless such resources do not exist or are impossible to verify.

a. TJC (CAMH)
b. AAAHC
c. DNV (NIAHO)

Answer 6

AAAHC