Learning
Credentialing
Compliance
Primary source verification (PSV) credentialing is becoming more of a challenge than a task. Original source data is more difficult to access, there are more licensed professionals, and verification timelines are getting tighter. In fact, 81% of respondents cited the speed and accuracy of verifications as the biggest credentialing challenge, according to a 2025 MedTrainer poll. It’s forcing a new standard of PSV credentialing.
In this blog post, I’ll lay out the new standard and explain in detail the challenges and trends that are forcing the change.
Webinar: Setting a New Standard for PSV
Core Elements of PSV Credentialing
Primary source verification (PSV) is the process of verifying a provider’s identity, background, and qualifications. Here are the basics of PSV credentialing:
Required Credentials
A healthcare provider’s education (including degrees and transcripts), professional licenses, board certifications, work history, sanctions, exclusions, and any other relevant credentials should be verified.
Original Source Verification
For PSV credentialing to be reliable, verification must come directly from the issuing authority such as licensing boards, accreditation organizations, or government databases. Relying on copies or self-reported credentials increases the risk of fraud and errors.
On-Demand, Reliable Access
The sheer volume of verifications required necessitates on-demand access to primary sources. Automated data retrieval and tracking of PSV credentialing status make it possible to generate reports and take real-time action.
Ability To Monitor Status Changes
A provider’s credentials can change unexpectedly due to expired licenses, new sanctions, or exclusions. Real-time monitoring and automated alerts allow organizations to respond immediately, preventing unqualified providers from delivering care. Staying proactive with PSV credentialing helps organizations avoid compliance violations and ensure patient safety.
Why PSV Credentialing Is Critical for Healthcare Organizations
Without proper verification, organizations may unknowingly employ unqualified providers, opening themselves to a range of serious consequences. Imagine a provider whose license has been revoked, but because of a missed verification or a delay in notification, they’re still seeing patients. The potential for harm is immense.
Failure to meet PSV credentialing requirements can lead to compliance violations, financial penalties, and even loss of accreditation from regulatory bodies such as CMS, The Joint Commission (TJC), and state licensing boards. Accrediting bodies often require proof of rigorous PSV credentialing processes, and failing to demonstrate them can have serious consequences. Again, on-demand access and near real-time updates are vital for maintaining compliance.
Financial repercussions are also very real. Compliance failures can lead to hefty fines, and even impact revenue. Payers may deny claims if they discover that services were provided by an improperly credentialed provider. Beyond fines, the reputational damage can also lead to decreased patient volume and lost revenue. The efficiency and accuracy enabled by on-demand access and near real-time monitoring are essential for minimizing these financial risks.
As fraud and misrepresentation cases rise, a proper PSV credentialing platform serves as a frontline defense, allowing for only properly vetted providers to deliver care. By implementing a rigorous, automated verification process, healthcare organizations can meet regulatory standards and maintain accreditation.
PSV Credentialing Challenges That Are Forcing Change
Primary source verification is becoming increasingly difficult as healthcare organizations face growing challenges in accessing and managing credentialing data. Many verification sources now use captchas, throttling, and other barriers that slow down or restrict automated data retrieval.
At the same time, the sheer volume of provider licensure has surged, requiring organizations to track multiple licenses, renewal cycles, and evolving regulatory requirements across different states and licensure compacts. These complexities, combined with resource constraints, make traditional verification processes inefficient and prone to errors.
The demand for faster, more reliable PSV credentialing is also driven by rising safety and quality standards and the need to quickly screen and onboard providers. Accreditation bodies like NCQA have shortened verification timelines, forcing organizations to adopt automated, real-time monitoring solutions. As fraud and misrepresentation risks increase, continuous compliance tracking is essential for maintaining a qualified and credentialed workforce.
Best Practices for Effective PSV Credentialing
Now is the time for healthcare organizations to set a new standard for PSV credentialing. It’s about moving beyond outdated, manual processes to a dynamic, data-driven approach with proactive risk management, streamlined efficiency, and unwavering compliance.
On-Demand Automation
Today’s credentialing professionals don’t have time to wait around — and neither do providers. Automating PSV credentialing reduces the administrative burden and minimizes the risk of outdated or incorrect information.
Verifications from the Original Source
To avoid compliance issues and delays, look for a PSV credentialing partner with API data solutions directly from the original sources. This reduces cost (as many states are now charging) and eliminates data access issues.
Image Capture for Compliance
Meeting accreditation requirements from organizations like TJC and DNV require image capture of licenses and certifications to demonstrate compliance. Modern primary source verifications should include secure document storage and tracking for audits.
Pricing Predictability
Many state licensing boards are now charging per verification. If you’re monitoring PSV with any regularity, this can add up fast. Be sure to choose a solution with inclusive pricing so that you can be confident in your compliance without breaking the bank.
Continuous Monitoring
A one-time verification isn’t enough. Real-time monitoring ensures that any license expirations, sanctions, or exclusions are detected in real-time, protecting both the organization’s patients and its revenue.
Board-Level Partnerships
Strong relationships with licensing boards and regulatory bodies provide more reliable verifications. The best PSV solutions prioritize these partnerships to enhance accuracy and efficiency.
How to Strengthen PSV Credentialing Using Technology
PSV credentialing is progressively improving efficiency, accuracy, and risk mitigation. The evolution of PSV is shifting from periodic checks to continuous monitoring, and from paper to automated processes. Technology makes it possible to verify licenses on-demand, such as when questions arise about a provider’s status or before a high-risk procedure. Traditionally, organizations verified licenses only at onboarding, renewal, and recredentialing, which left gaps in compliance.
Here’s what to look for:
- Automation: Automate as much of the PSV credentialing process as possible, from data retrieval and tracking to report generation and alerts. This frees up you and your staff to focus on higher-value tasks.
- Real-time data access: Invest in systems that provide on-demand access to primary sources and near real-time updates on provider credentials. This is crucial for continuous monitoring and proactive risk management.
- Data analytics: Leverage credentialing data to identify trends, track key metrics, and improve the efficiency and effectiveness of your PSV process. Analyze turnaround times, error rates, and other data points to pinpoint areas for improvement.
To reach the new PSV standard, organizations must move beyond outdated methods and focus on proactive strategies. See what automation looks like.
Start Your PSV Transformation Today
The new standard for PSV credentialing requires on-demand automation, original source access, image capture, and pricing predictability. With this in place, your organization can remain compliant and catch provider status changes in near-real time to ensure patients receive the highest quality care.
Using a healthcare credentialing platform, such as MedTrainer, simplifies this new standard, which can be daunting if you’re trying to meet it with an outdated or manual process. MedTrainer offers automated license verifications for all states and license types with image capture and the ability for verification to be completed by a human and automatically tracked.
Learn more about how MedTrainer is transforming PSV through automation and strategic partnerships. Get started today.