NCQA Primary Source Verification Checklist: Simplify Credentialing Accreditation

The National Committee for Quality Assurance’s (NCQA) 2025 credentialing standards are a clear push to modernize credentialing practices across the healthcare landscape. With increased expectations around accuracy, timeliness, and accountability, Primary Source Verification (PSV) sits at the center of these changes. Having an NCQA Primary Source Verification Checklist ensures your credentialing team stays aligned with evolving standards and audit-ready at every step.

Starting July 1, 2025, healthcare credentialing teams will face higher stakes. Verifying credentials isn’t enough. Organizations must now prove that their PSV processes are consistent, traceable, and secure. Relying on cumbersome or scattered methods can expose your organization to compliance risk, onboarding delays, and reputational damage.

Setting a New Standard for PSV

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What’s Different Starting in 2025 — And Why It Matters

While PSV – and leveraging technology to complete it – has always been foundational to credentialing, the 2025 NCQA updates raise the bar in several meaningful ways:

• Faster Turnaround Requirements: Teams must complete PSV within tighter timeframes, reducing delays in provider onboarding and care delivery.
• Ongoing Monitoring: NCQA now expects continuous oversight, not just point-in-time checks.
• Defined Roles and Documentation: Organizations must assign clear responsibilities and maintain defensible, audit-ready records.
• Real-Time Auditability: Surveyors should be able to see the status of any PSV file instantly — no manual digging required.

Below is a step-by-step NCQA primary source verification checklist to help your team stay aligned with their updated requirements, along with what to look for in credentialing management software to more efficiently complete primary source verification for physicians. 

Creating an NCQA Primary Source Verification Checklist

1. Establish Clear Policies and Procedures

Start with written policies that outline:

• The credentialing elements requiring primary source verification
• Approved sources and methods for each verification
• Role-based responsibilities for credentialing staff
• Required documentation (e.g., verification date, source, outcome)

Using an all-in-one healthcare credentialing platform, teams can create, manage, and distribute credentialing policies in the same system. This one source-of-truth approach allows every user to follow consistent standards, receive the right information, and sign off when needed.

2. Use Approved Primary Sources for Core Credentialing Elements

NCQA defines specific elements that must be verified through primary or NCQA-approved sources. These include:

• State Licensure: Verified with state licensing boards
• DEA/CDS Registration: Verified through DEA or state agencies
• Education & Training: Verified directly with schools or programs
• Board Certification: Confirmed with ABMS, AOA, or other accepted sources
• Work History: Verified via CV or documented review
• Malpractice History: Reviewed through NPDB or carrier reports
• Disciplinary Actions: Checked with state boards and OIG
• Medicare/Medicaid Sanctions: Cross-checked against exclusion databases

A modern credentialing platform stores and actively connects PSV documentation to primary sources. Through direct API integrations with state licensing boards and other NCQA-approved sources, users can get real-time status updates, eliminate the need for manual lookups, and ensure each credential is automatically linked to its verified source. 

3. Document Everything – Consistently and Completely

Each verification must include:

• Verification source
• Verification date
• Name/initials of the person verifying
• Verification result or outcome

It’s best to have a credentialing system that both tracks PSV status and verifies it. An automated license verification tool will pull directly from primary sources, prompting a human reviewer to confirm the verification, record the outcome, and mark it as complete. 

Each step is time-stamped, stored in a centralized location, and reflected in real-time reports. This way, you can see what’s done, what’s pending, and what’s outdated, all in one place.

4. Monitor for Sanctions and Changes Continuously

One-time or sporadic verification isn’t enough. NCQA now expects teams to:

• Recheck sanction/exclusion databases at regular intervals
• Flag and respond to quality issues or license actions
  Document when and how updates are made

Built-in monitoring tools and configurable alerts help your team stay ahead of disciplinary actions and sanction changes by automatically checking key exclusion sources, including OIG, SAM, and applicable state databases.

5. Audit Regularly and Resolve Gaps

No healthcare credentialing program is above internal audits. At a minimum, healthcare organizations should:

• Audit credentialing files annually
• Identify and address documentation gaps
• Maintain records of corrections and follow-up reviews

Robust credentialing software can instantly generate reports by provider, element, or timeframe, making internal audits faster, more accurate, and easier to document.

6. Don’t Present a File Without Final PSV Completion

Before any file reaches the credentialing committee, organizations should ensure:

• All PSV elements are complete and verified
• Application and attestation are signed and dated
• Supporting documentation is uploaded and accessible

Automated checks and built-in workflows can flag incomplete files so that no record advances without full PSV completion, saving time and reducing risk.

Automated checks and built-in workflows flag incomplete files and prevent records from advancing without full PSV completion, saving time and reducing risk. With automatically generated credentialing packets, teams can also leverage a real-time status checklist that highlights missing, outdated, or expired items at a glance.

How MedTrainer Can Help

Creating an NCQA Primary Source Verification under the 2025 standards demands more than speed — it requires structure, transparency, and proof. MedTrainer’s credentialing platform is built with these realities in mind, combining automation, oversight, and built-in compliance support to help healthcare organizations streamline PSV from start to finish.

Some of the MedTrainer features designed to help credentialing teams meet NQCA expectations and beyond include: 

• • PSV Built Into Workflows: Verification steps are seamlessly embedded into credentialing processes. Each verification step — from license checks to sanction monitoring — is automatically aligned to NCQA standards and audit-ready by default.
  • AI-Driven Efficiency: AI Upload Assistant reduces repetitive data entry and speeds up form completion by extracting critical data from provider documents and placing it exactly where it needs to go.

• Verified Source Integration: Through partnership with Propelus, MedTrainer connects directly to state licensing boards via API, enabling automated, real-time primary source verification.

• Ongoing Exclusions Monitoring: Tracks expirations and sanctions automatically with alerts and dashboards. 
• Transparent Reporting: Every PSV activity is automatically time-stamped and logged. Custom reports show real-time status, completion timelines, outstanding verifications, and ownership.
• Clear Task Ownership: MedTrainer supports role-based responsibilities with the ability to assign PSV tasks to specific users and maintain visibility into who completed what and when.

With MedTrainer, Primary Source Verification becomes faster, smarter, and fully aligned with NCQA requirements. See why MedTrainer is the healthcare credentialing software teams trust to stay audit-ready and ahead of the curve. Learn more today.