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

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How recent must verifications be according to NCQA?

90 days

120 days

180 days

The National Committee for Quality Assurance (NCQA) mandates that verifications of credentials must be conducted within a specific timeframe to ensure the accuracy and reliability of provider data. According to NCQA standards, verifications must be no older than 180 days at the time a healthcare organization conducts a credentialing decision.

This timeframe is important because it helps maintain the integrity of the credentialing process, ensuring that all information regarding a healthcare provider's qualifications, training, and any disciplinary actions are current and reflective of their professional status. By requiring updates every 180 days, NCQA aims to uphold quality in healthcare services and the safety of patients receiving care.

While other timeframes, such as 90 days, 120 days, or 365 days, may exist in different contexts or requirements, the specific requirement set by NCQA is 180 days, making it a critical benchmark for credentialing professionals to follow.

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365 days

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