Credentialing

Primary Source Verification, Primary source credentialing

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December 20, 2021

As a healthcare facility owner or credential manager, the last mistake is onboarding medical personnel with fake credentials into your system. The error comes with grave consequences and costs the healthcare facility its credibility.

Primary source verification is a critical aspect of the credentialing process. All physicians, nurses, and other medical staff must pass through a thorough credentialing process before being authorized to practice at a facility.

In preparation for routine accreditation surveys, it is crucial that the credential manager effectively manage and organize the credential information of all staff in the medical facility. Primary Source Verification (PSV) is also essential for the accuracy of all personnel credentialing documents.  

What Is Primary Source Verification?

Primary Source Verification is the process of verifying the credentials of a healthcare provider, such as state or federally required certification, licensure, training, and education with the source.

During Primary source verification, contact with the source for verification is made through the mail, telephone calls, and other secure electronic communication.

The Joint Commission (one of the main accrediting bodies in the States) requires that Primary source verification is performed at hire and the point of renewal. Also, the health providers’ license must be in good standing throughout their employment.    

Difference Between Primary Source Verification And Medical Credentialing?

While medical credentialing ensures that healthcare providers have the right training and experience to provide healthcare service to patients, Primary Source Verification is the verification of a healthcare provider’s credentials directly with the issuing authority.

Primary source verification is one of the major processes that must occur while undergoing medical credentialing.

What Is Considered A Primary Source?

The issuer of the credential document is referred to as a primary source. For instance, the primary source of your education is your medical school, not your certificate.

  • The primary source of a DEA License education is the Drug Enforcement Agency Medical schools
  •  The primary source of board certification is the issuing board
  •  The primary source of Postgraduate training is the Residency predoctoral programs
  •  The primary source of a state medical license is the Issuing State Licensing Board

As a credential manager, you should not accept any verification document from the physician under verification. No third party must be involved in validation unless the accreditation organization certifies them.

Why Do Healthcare Organizations Need Primary Source Verification?

The priority of every healthcare organization is to ensure patient safety, and primary source verification is a crucial contributor to this objective.

In situations, unlicensed and unqualified medical practitioners pretend to be actual medical practitioners.

They do this by utilizing fake college degrees, lying in resumes, counterfeit licenses, etc., to secure employment. Without primary source verification, it will be impossible to authenticate the validity of the credentials provided by the healthcare provider.

Employing an unlicensed/fraudulent practitioner carries a heavy liability risk on the healthcare

organization. Massive sanctions and penalties are attached to healthcare organizations that consciously or unconsciously allow unqualified practitioners through their doors.

It is crucial never to employ any provider without required credentialing through primary source verification.

Credentials Verified Through Primary Source Verification.

Some of the credentials needed to get verified through primary source verification include;

  • Board certifications
  • Federal and State DEA certificate
  • Medical education
  • National Practitioner Data Bank
  • Training programs (internships, Residency, or Fellowship)
  • Medicaid Sanctions list
  • Medicare Preclusion list
  • Medicare Opt-out list
  • National Provider Identifier Standard (NPI)
  • Hospital affiliation verification
  • Work history

Traditional methods for Primary Source Verification

Accrediting bodies like the Joint Commission, GL, Det Norske Veritas (DNV), and Healthcare Facilities Accreditation Programs (HFAP) require healthcare organizations to primary source verify according to their set forth standards.

Traditionally, primary source verification requires many human resources and administrators to perform verifications via a manual license lookup. While many primary sources and state boards have an electronic database with certification/license information that you can access on a secure website, others haven’t gone digital. 

In the absence of digitization, verification is carried out via telephone calls, written correspondence, or electronic fax.

All records of verification exercises carried out by your credentials manager must be appropriately stored, as regulatory authorities may ask the healthcare facility to provide proof of verification. In these cases, hospital representatives must present evidence of the confirmation for the medical practitioner, including the date of verification.

The Best Approach To Primary Source Verification

At a minimum, you should carry out verification during hire and renewal. However, most regulatory bodies require that all healthcare providers have valid licenses at all times. As significant changes in licensure can occur at any time, it is inadequate to verify only at hire and renewal time.

The best approach is to verify as often as possible. It can be tedious to manually keep up with license and verification requirements updates. However, by automating this process with Float Care, the verification process can be performed quickly and efficiently without requiring much staff time.

By automating verification with Float Care, you can keep all medical credentials in one place and stay on top of requirements and expiration dates. 

Contact us today for more information about how our solutions can help you.


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