Centralized Credentialing

Health systems composed of multiple health care entities (e.g., several hospitals, outpatient surgery centers, and clinics) often have practitioners providing health care services at more than one of their health care entities. If a health care system conducts its credentialing centrally, has a centralized peer review process, and has one decision-making body, the health care system may query the NPDB once on each practitioner during the professional review process, regardless of whether the practitioner provides health care services in one or multiple entities. However, if the system's health care entities each conduct their own credentialing, and each health care entity grants privileges to provide health care services only in its facility, each health care entity must query the NPDB separately on its own practitioners. In these instances, sharing query responses is prohibited. See Data Bank Identification Numbers in Chapter B: Eligible Entities.

The work of querying in a health system environment composed of multiple health care entities is often performed by a Credentials Verification Organization (CVO), which gathers data and verifies credentials of physicians and other health care practitioners on behalf of its own organization or other organizations. CVOs examine numerous sources in addition to the NPDB as they gather credentialing information.

A CVO operating in an environment with a centralized peer review process and decision-making body should register with the NPDB as a single entity. A CVO should register with the NPDB as an agent if each health care entity for which it works conducts its own credentialing and grants privileges at its own facility. When a CVO is registered as an agent, each facility for which it works must register separately with the NPDB as a health care entity.