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

An organization must conduct an audit of the credentialing process delegated to another organization annually, according to the National Committee for Quality Assurance (NCQA). This requirement ensures that the organization is actively monitoring and evaluating the performance and compliance of the delegated entity with established credentialing standards.

Conducting an annual audit allows organizations to identify any potential issues or inconsistencies in the credentialing process in a timely manner, which is essential for maintaining quality healthcare delivery and compliance with regulatory requirements. Regular audits contribute to quality assurance and help to mitigate risks associated with credentialing, ensuring that only qualified providers are granted privileges.

The other options, while representing varying frequencies, do not align with the NCQA's standards, which prioritize more frequent evaluations to address the dynamic nature of credentialing and the healthcare landscape.