Why Insist on Primary Source Verification?

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In the world of medical credentialing, it’s essential to ensure that information and documentation are accurate. The best way to accomplish this is by using a primary source to verify provider credentials.

Primary source verification uses direct, or primary, sources to verify practitioner information. A primary source can be an organization, body or person who actually issued the information. As a primary source, these entities would have direct and verifiable knowledge of the validity of that information.

Examples of Primary Sources

Specifically, when verifying licensing, education, training history and certifications, the body that issued those documents would be the primary source and can be:

Federal and state government agencies for licensing, sanctions, the National Practitioner Data Bank, state certifications, military records, criminal history and background checks.

  • Educational institutions for post-graduate training records and medical school.

  • Hospitals for privileges granted.

  • Employment sources for work history.

  • Professional associations for certifications and affiliations.

To verify a peer reference as supplied by a provider, primary source verification requires direct personal contact. Not only can you verify the accuracy of the information but you can further assess the provider’s relationship with the individual to make sure it fits your policies.

Failure to verify the accuracy of information amounts to negligent credentialing and can expose your practice to considerable legal and regulatory risk.

What Are Not Primary Sources for Verifications?

Verifying documents directly from the practitioner are not primary sources – they must come directly from the issuer.

Here are some examples of sources that are not primary:

  • Document photos

  • Information provided by the physician

  • Information provided by a medical school professor

Remember, your patients’ safety is of utmost importance, and you also don’t want to expose your organization to significant regulatory and legal risk. Primary source verification is the industry standard and critical for accurate and verifiable credentialing.

Let Us Manage All Your Payer Enrollment and Credentialing Services

If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.