Mastering Primary Source Verification: Solutions for Healthcare Organizations

Patients trust their healthcare providers to take care of them when they’re vulnerable, which is why insurance payers, regulatory agencies, and accreditation organizations place great emphasis on primary source verification, the process of ensuring the accuracy of provider credentials.

Accurate and thorough primary source verification protects healthcare organizations from legal liability, penalties, and potential loss of accreditation. Vetting new employees is the first step in maintaining patient safety and earning their confidence.

This article provides an overview of the primary source verification process. From answering the question “what is primary source verification” to describing the challenges and how to overcome them, you’ll gain a deep understanding of what is required and how it benefits the healthcare organization.

Do's and Don'ts of AI and Credentialing

Register Now

What Is Primary Source Verification?

In short, primary source verification (PSV) is the process of confirming the accuracy of a provider’s credentials and qualifications. This process involves collecting documents to verify education, training, licensure, certification, work history, and other relevant information directly from the primary source, such as the issuing institution or organization. For accountability, the name of the person who completed the verification is logged, along with the trusted source and date of verification.

Primary source verification is important for the following reasons:

• Reduces the risk of hiring unqualified professionals 
• Mitigates liability risks and financial losses associated with non-compliance
• Maintains compliance with CMS and Joint Commission standards
• Enhances organizational reputation with the employment of quality professionals
• Promotes a culture of integrity, safety, and professionalism
• Saves money by reducing liability costs that are greater than the cost of PSV

What Types of Credentials Require PSV?

The specific requirements for primary source verification may vary depending on the organization, jurisdiction, and type of healthcare service provided, but generally, the following types of credentials and qualifications require verification:

• Licensure
• Certifications
• Education
• Work experience

It’s a critical process for healthcare organizations to ensure that their providers are qualified, competent, and trustworthy. By verifying the authenticity and accuracy of a provider’s credentials and qualifications, healthcare organizations provide high-quality care for their patients and maintain the trust and confidence of the community.

Methods for Completing a Provider’s Primary Source Verification

When verifying a new hire’s credentials, there are several ways to collect the information. It comes down to how much time and resources you’re able to dedicate to PSV. Here are some different ways to properly verify credentials:

Direct Contact

One of the most common methods for completing primary source verification is direct contact with the issuing institution or organization, such as a medical school, licensing board, or certification organization. This involves verifying the provider’s credentials and qualifications directly with the organization — usually by phone, email, or online.

Digital Verification

Another method for completing PSV is through digital verification platforms, which provide either direct access to the original source or to verified provider information and credentials from multiple sources. The ideal digital verification offers a direct link to the original source and pulls the document information and image directly into your credentialing software. You have confidence knowing you’ve verified with the primary source, but you don’t have to leave your existing credentialing workflow.

Third-Party Verification Services

Some healthcare organizations use third-party verification services to conduct PSV. These services typically have access to primary source data and can verify provider information quickly and efficiently. MedTrainer’s managed credentialing service is an example of a third-party service that handles PSV from start to finish as part of the full credentialing process.

Common Challenges in the Verification Process

While PSV credentialing is a critical process for healthcare organizations, it comes with many challenges to overcome. Here are some of the common problems with PSV:

• • Time-Consuming. Collecting information and documents from providers can take several weeks or months, which results in costly delays as the organization waits to earn revenue. These delays also impact the organization’s operational efficiency.
  • Inconsistent Standards. Different organizations and jurisdictions may have varying standards, renewal cycles, and requirements for PSV, making the process more complex and time-consuming. This can lead to errors or inconsistencies in the information collected, affecting the accuracy and reliability of the primary source verification process.
  • Credentialing Errors. Errors or inaccuracies can be due to mistakes made by the provider or the issuing institution or due to incomplete or outdated records. Such errors can lead to delays in provider onboarding, potential liability issues, and other operational inefficiencies.
  • Data Access. Most state licensing boards are now offering documents online, but the sheer volume of today’s licensed providers and security protocols can make it difficult to access data. There is often an associated cost or CAPTCHA fields that slow the process.
  • Cost. PSV can be expensive, especially for organizations that have a large number of providers to verify. This can be due to the time and resources required to collect and verify the necessary information and the fees charged by healthcare credentialing and verification organizations.

Internal Credentialing: Best Practices To Keep Pace

Watch Now

How Technology Streamlines Primary Source Verification

Primary source verification for physicians is a time-consuming process with multiple steps, coordination with providers and government agencies, and even deliberately slow data-retrieval processes. It’s why most healthcare organizations are adopting credentialing software to complete the PSV process more quickly and accurately. In fact, NCQA updated its credentialing standards in 2025, effectively forcing the adoption of technology in PSV. Whether you’re an experienced credentialing professional or just starting to ask yourself, “What is primary source verification?” Here’s a look at how technology can help.

On-Demand Automation

Automating PSV credentialing reduces the administrative burden, increases accuracy, and speeds up the process. Automated license verification should pull in the license details as well as an image of the license, so it’s easy for a staff member to verify the accuracy.

Primary Source Integration

Choosing software with an API data integration with state licensing boards, and even the DEA, will ensure you’re getting the most up-to-date, accurate information. Plus, you might also be able to avoid the fees charged by some state licensing boards.

Image Capture for Compliance

The Joint Commission and DNV require an image of the provider’s license to be retained on file, so when evaluating technology, look for a solution that includes image capture and storage as part of the provider data management system.

Expiration Reminders and Reports

NCQA requires that accredited organizations keep track of license expiration dates — and that’s something that healthcare credentialing software can do for you! In addition to meeting the NCQA standards, it keeps you in a proactive position so that providers are able to see patients. Look for recurring automated emails that start up to 180 days before expiration and customizable reports with the license expiration date that can be emailed regularly.

MedTrainer: A Proactive Approach to Healthcare Primary Source Verification

MedTrainer credentialing software streamlines the primary source verification process with automated license verification, an industry-leading partnership with Propelus, and customizable reporting that keeps you a step ahead.

By using a healthcare credentialing platform like MedTrainer, healthcare organizations can reduce the administrative burden of the PSV process, improve accuracy and consistency in verifying provider information, and accelerate the onboarding of new providers. This can result in improved operational efficiency, reduced risk of liability, and a more positive experience for providers and patients.