Application Processing and Primary Source Verifications - What's Included

TPQVO provides a complete packet of application processing, primary source verification and document collection services.  As a minimum, TPQVO uses only NCQA and Joint Commission approved applications, primary sources and methods for collecting and verifying credentialing information on behalf of our clients.  You will receive a certified copy of verifications as part of your credentialing package.

Clients may request some or all of the following services (please see packages to the right):

INITIAL APPLICATION

Application Processing

Profile Sheet (Verification Summary)

Copy of:

• Initial Appointment Application
• Curriculum Vitae
• Medical School Diploma
• Residency Certificate
• Current Valid State License(s)
• DEA Certificate
• Certificate of Insurance
• Continuing Education Credits for the past 2 years
• Copy of Driver's License or U.S. Government-issued Passport

Verification of:

• Training, including professional school, internship, residency, fellowship
• Liability Insurance and Claims History for past 5 years
• All licenses, past and present
• DEA Registration, State Narcotics license
• Medicare/Medicaid Sanctions
• GSA Excluded Parties List
• National Sex Offender Database
• State Patient Abuse Registry
• Work History (past 5 years)
• Past and Current Hospital Affiliations
• Board Certification
• Teaching Appointment(s)

National Practitioner Data Bank query (under client's DBID as its agent)

Three Peer References

RECREDENTIALING

Application Processing

Profile Sheet (Verification Summary)

Copy of:

• Reappointment Application
• All current state licenses
• DEA Certificate
• Certificate of Insurance
• Copy of Continuing Education Credits for past 2 years

Verification of (past 2 years or 3 years for managed care):

• License(s)
• License Sanctions
• DEA Registration, State Narcotics license
• Medicare/Medicaid Sanctions
• GSA Excluded Parties List
• National Sex Offender Database
• State Patient Abuse Registry
• Liability Insurance and Claims History
• Board Certification
• Hospital Affiliations
• Teaching Appointments

National Practitioner Data Bank query (under client's DBID as its agent)

Three Peer References

RECREDENTIALING

Clients will be responsible for notifying TPQVO in advance of practitioners requiring recredentialing unless the client uses TPQVO's Standard recredentialing schedule.  Standard recredentialing schedules for Physicians and Allied Health Providers are organized by specialty and allow region-wide recredentialing to occur at the same time every two years.  This standardization allows TPQVO and client organizations to save time and money and reduces hassle for healthcare providers by limiting requests for applications and supporting documentation.

Clients using TPQVO to process both initial applications and recredentialing will also receive document update and notification services.

DOCUMENT  UPDATE/ NOTIFICATION SERVICE

If clients elect to use TPQVO's document update service and once TPQVO has processed a health care professional, TPQVO will monitor expiration dates and request from the provider an updated copy of:

• License (client's state)
• Insurance Policy
• DEA Certificate
• Board Certification

TPQVO will verify the updated license/certificate and send a copy of the document and TPQVO's verification of that license/certificate to the client.  (TPQVO will not verify new certificates of insurance.)

In addition, TPQVO monitors state licensing board disciplinary releases (for the primary state licenses) and the HHS Office of the Inspector General Medicare Medicaid sanctions reports.  TPQVO will notify clients of any matches with healthcare professionals TPQVO has processed on the client's behalf.

For more specific information or for a proposal tailored to meet your organization's needs, please contact us.