Your Credentialing Partner


TPQVO, Inc. Credentials Verification Services

Physician Application Forms and Credentials Verification Process

If you are eligible for privileges as a member of the Active Medical Staff (for example, physician, dentist, podiatrist) of a TPQVO client facility, you will need to complete the appropriate application form listed on the FORMS page. 


Initial Application Process

Some TPQVO client organizations require pre-application screening and will not accept an application without first contacting the medical staff or professional relations office.  Please contact the healthcare organization's office first if you have any question about your eligibility for membership/affiliation. 


Reappointment Applications

TPQVO will send the appropriate application for reappointment or recredentialing to medical staff and network members according to the regional recredentialing schedule.  Therefore, these forms are not available through this website.

Depending upon the healthcare organization to which you are applying, forms are available for download on this page in Adobe Reader format.  The forms may be filled and printed and then sent or faxed to TPQVO for processing.

If you have any questions about which form to use please call the healthcare organization (TPQVO client) to which you are applying or reapplying for privileges.


File Set Up and Query Fees

There is a one-time file set up fee charged for any first time application for initial privileges.  This fee is noted on the application cover letter describing all necessary documentation that you must send in with your completed application.  TPQVO will not begin processing your file until this fee is paid.  Also, most healthcare organizations will not accept an application as complete without the additional items listed on the cover letter.

Additionally, TPQVO will bill you for any primary source query fee (i.e., graduate schools, national certification boards) charged to TPQVO for providing a verification of your credential.   You will not be billed for information TPQVO can reuse from previous times your file was processed for a TPQVO client facility. 

If you've received an invoice from TPQVO for query or set up fees or both, you may pay for these by credit card via a secure payment gateway.  Make sure you have your invoice available and go to the "credit card payment" page on this site.  For more information about TPQVO's credit card policies, you can read these policies here.


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Copyright 2002 TPQVO, Inc.
Last modified: April 28, 2016