Credentialing Chronicles
"Credentialing Chronicles" is the go-to podcast uncovering the hidden truths and scandals in healthcare credentialing, licensing, and compliance. Hosted by industry experts, we dive into real cases, juicy controversies, and insider knowledge that every persons needs to know! 🎙️🔥
Credentialing Chronicles
Episode 21: NCQA Said NOPE!
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NCQA Said Nope – CVO Edition
When NCQA says “no,” they mean no. In this brutally honest, laugh-out-loud episode, Shannen and Nyleen pull back the curtain on Credentialing Verification Organizations (CVOs) — the certified, the expired, the denied, and the ones hiding behind the term “NCQA aligned.”
From decoding NCQA statuses to real-life horror stories of outsourcing gone wrong, they’ll give you the insider checklist to vet your vendors, avoid audit nightmares, and protect your reputation. Whether you’re a credentialing pro, a health plan exec, or just curious about who’s verifying your providers, this episode is your wake-up call.
Edgy. Fun. Real. And yes, there’s plenty of tea.
Resources Mentioned:
🔎 Verify Your Doctor’s Credentials
✔️ State-Specific Medical Board License Lookup:
Find your state’s board here:
https://www.fsmb.org/contact-a-state-medical-board/
✔️ Medicare Exclusions List (LEIE) – Check if your provider is federally excluded:
https://oig.hhs.gov/exclusions/exclusions_list.asp
✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts
For Medical Staff Professional:
✔️ FSMB.org – Federation of State Medical Boards Physician Lookup:
https://www.fsmb.org/physician-license-lookup/
✔️ Hospital Websites:
Many hospitals have public directories listing credentialed medical staff. Look for a “Find a Doctor” or “Medical Staff Directory” page.
✔️ Set Google Alerts on Your Doctor’s Name:
Create your own Google Alert here:
https://www.google.com/alerts
Wanna know if your plastic surgeon is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon
Open Payments
openpaymentsdata.cms.gov
Verify your Nurses' Credentials:
https://www.nursys.com/
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