Special Report: Credentialing

JCAHO insists on primary verification

Choose your CVE with care

The Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, determined late in 1995 that the American Medical Association’s (AMA) Physician Masterfile adequately addresses the "Principles for Users of External Agencies for Primary Source Verification of Creden tials," and therefore that its use meets Joint Commission primary source verification requirements set forth in the Medical Staff standards of the Accreditation Manual for Hospitals.

The Manual now states that "at the time of appointment and initial granting of clinical privileges, the hospital obtains verification of relevant training or experience from the primary source, whenever feasible. . . . Infor ma tion from credentials verification organizations (CVEs) such as the Physician Masterfile may also be used."

Then, in MS 5.4.3.2, it states, "The hospital is also encouraged to consider additional information . . . from other sources [that] may provide . . . information that is new or that may flag an inconsistency when compared with the individual’s application."

Under Intent, the document states that "hospitals may use an external agency . . . to collect information from primary sources provided that the agency also furnishes the hospital with any additional information from the primary sources." Under Example, the document lists eight principles for evaluating CVEs.

The AMA’s Physician Masterfile contains credentials on all American physicians (more than 805,000 physicians), not just members of the AMA, and DOs are included. The listing contains primary source-verified biographic and demographic information, including medical education and residency training, licensure status, federal Drug Enforcement Administration registration, American Board of Medical Specialties’ board certification, and other core data. The file also provides an alert of all final licensure disciplinary actions and sanctions by the Department of Health and Human Services. The AMA charges $15 per physician for the information.