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.
Support the show (https://www.buzzsprout.com/2460053/support)
Resources Mentioned:
Verify your Nurses' Credentials:
https://www.nursys.com/
🔎 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 doctor is actually board certified?
Check for yourself right here:
👉 Verify a Plastic Surgeon (https://www.abplasticsurgery.org/public/verify-certification/VerifyCert?section=SurgeonSearch)
Because credentials do matter. 🩺✨
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