Designated Equivalent Sources

Question 1

TJC
Designated Equivalent Sources

Answer 1

Designated equivalent sources may be used to verify certain credentials in lieu of using the primary sources. Designated equivalent sources include but are not limited to:
- AMA Physician Masterfile for a physician’s US or Puerto Rican medical school graduation and residency completion
- ABMS for a physician’s board certification
- ECFMG for physician’s graduation from a foreign medical school
- AOA Physician Database for physician’s predoctoral and post doctoral education and training including dates of attendance and completion, ABMS specialty training and MOC participation status, accredited continuing education status,
- FSMB for all action against a physicians medical license
- AAPA profile for PA education and NCCPA certification

Question 2

NCQA
Designated Equivalent Sources

Answer 2

CR 3
NCQA does not use the language ‘designated equivalent sources’. See each credentialing element for a listing of NCQA approved sources.
CR 8 Verification of credentials through an agent that contracts with an approved source to provide credentialing information is allowed. Prior to using this method documentation must be obtained from the agent indicating that there is a contractual relationship between it and the approved source.

Question 3

ACHC Acute Care Hospitals
Designated Equivalent Sources

Answer 3

The following sources are recognized
- FSMB or Fraud and Abuse Control Information Systems (FACIS) for actions against a physician’s medical license
- AMA Physician’s Profile, AOA Official Osteopathic Physician Profile, for verification of medical education and postgraduate training
- ECFMG for verification of foreign medical education
- NPDB query for professional liability actions resulting in final settlements or judgments within the past five years
- If certified by a member of board, ABMS, verify board certification with ABMS; if certified by a specialty board with AOA, verify with AOA Official Osteopathic Physician Profile

Question 4

DNV NIAHO For Hospitals
Designated Equivalent Sources

Answer 4

DNV standards do not use the language ‘designated equivalent sources’, but does recognize AMA.AOA profiles and ECFMG as acceptable verification sources

Question 5

URAC Health Plan
Designated Equivalent Sources

Answer 5

URAC does not use the language ‘designated equivalent sources’. Verification sources are identified for each credentialing element.
An organization can rely on the verification activities of state licensing boards. It this is done, it should be noted in the credentials file. Confirm that the state board does verify a credential before relying on the board.

Question 6

AAAHC Ambulatory Health Care
Designated Equivalent Sources

Answer 6

• AAAHC refers to ‘secondary sources’. Secondary source verification is documented verification of a credential through obtaining a verification report from an entity that has performed primary source verification of that credential.
• Information received from any such sources must meet the same transmission and documentation requirements as primary source verification
• Information received from a CVO is also acceptable as long as it meets the CVO requirements

Question 7

Medicare Hospital COPS Interp Guidelines
Designated Equivalent Sources

Answer 7

Not specifically addressed.