CVOs/Delegation

Question 1

TJC
CVOs/Delegation

Answer 1

The CAMH 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, processes 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 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

Question 2

NCQA
CVOs/Delegation

Answer 2

CR8 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 systems controls, the delegated activities, the process for evaluation and outcomes if obligations are not fulfilled.
There must be at least, semiannual reporting by the delegated entity to the organization.
If the CVO achieves NCQA certification for al delegated credentialing elements, this oversight responsibility is waived

Question 2

ACHC
CVOs/Delegation

Answer 2

A professional credentialing organization, such as a CVO, can be used to perform primary source verification, but the process for credentialing by the organization must reflect the requirements as stated in the standards

Question 2

DNV
CVOs/Delegation

Answer 2

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.

Question 3

URAC
CVOs/Delegation

Answer 3

The organization can delegate credentialing. It it does, it must establish and implement criteria and assessment processes prior to the 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.

Question 4

AAAHC
CVOs/Delegation

Answer 4

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. (Page 333 AAAHC Standards Handbook)

Question 5

Medicare Hospital COPS
CVOs/Delegated

Answer 5

Not specifically addressed