Certified Provider Credentialing Specialist Showdown 2025 – Master the CPCS with Confidence!

The correct answer is that Managed Care Organizations (MCOs) are required by the National Committee for Quality Assurance (NCQA) to recredential practitioners at least every 3 years. This requirement is in place to ensure that practitioners maintain their qualifications and adhere to changing standards in healthcare delivery.

Recredentialing every 3 years allows MCOs to regularly assess a practitioner's ongoing education, any history of malpractice claims, disciplinary actions, and current clinical capabilities. This is crucial for patient safety and the quality of care that MCOs provide. By performing recredentialing at this interval, MCOs can effectively keep their provider networks up-to-date with competent medical professionals, ensuring that they are meeting the latest standards of care and adhering to best practices in their specialties.

The other options suggest intervals that are either too frequent or too infrequent compared to NCQA requirements. Annual recredentialing would place an excessive burden on administrative resources, while credentialing every 5 years does not meet the standards necessary to ensure consistently high-quality provider performance. Therefore, recredentialing every 3 years provides a balanced approach that supports both provider assessment and organizational efficiency.