Credentialing Standards   /   March 2016

CredSimple is NCQA Certified for Credentials Verification

CredSimple is NCQA Certified for Credentials Verification

CredSimple is now an NCQA Certified CVO

NEW YORK, March 1, 2016 /PRNewswire/ — CredSimple, the leading SaaS platform for real-time credentialing of medical providers and facilities, today announced that it has received its Credentials Verification Organization (CVO) certification from NCQA, a private, non-profit organization dedicated to improving healthcare quality. As a certified CVO, CredSimple has demonstrated that its platform provides the confidentiality protections required by NCQA’s standards with a sound management structure that ensures data integrity by monitoring and continuously improving the quality of its service. With this certification, CredSimple will be able to scale its business and aid larger healthcare organizations with their credentialing and provider data challenges.

“We are proud to have obtained such an important industry certification at such an early stage in our company’s journey,” said Mike Simmons, CEO of CredSimple. “In our business, compliance is our lifeblood and the NCQA certification means that we’re growing quickly in the right direction.”

As a startup of only three years of age, CredSimple views market disruption through a different lens than its counterparts in the startup world. Instead of fighting industry standards and regulations, the team has created a core competency of innovating within a strict set of regulations — they think “outside-the-box, inside-the-framework.” Earning this coveted NCQA certification will allow CredSimple to reach large, nationwide healthcare organizations who recognize the need for more innovative ways to manage credentialing and provider data, but require highest standards of compliance to established certifications to move forward.

“Recognition as an NCQA CVO demonstrates that CredSimple has the necessary tools to guide healthcare providers, facilities and organizations on a number of difficult and complex provider data management requirements,” said Margaret E. O’Kane, President of NCQA. “For a young company, we were impressed with CredSimple’s data management practices and dedication to compliance.”

The NCQA Certification process includes rigorous on-site and off-site evaluations conducted by a survey team that includes at least one CR surveyor and one administrative surveyor.  A Review Oversight Committee (ROC) of physicians analyzes the team’s findings and assigns a certification status based on the CVO’s performance against core standards and the requirements within applicable certification options.

“We hold the NCQA’s already high standards as a minimum baseline for quality and consistency for our own product,” said Dr. Garry Choy, Chief Medical & Compliance Officer at CredSimple. “This commitment to quality in our technology platform and services shows in our certification scores of 100% across all 10 elements of credentials verification.”

CredSimple has received certification from NCQA for 10 out of 10 verification services:

  • License to practice
  • DEA Certification
  • Medical Board Sanctions
  • Education and Training
  • Malpractice Claims History
  • Medicaid/Medicare Sanctions
  • Work History
  • Practitioner Application Processing
  • CVO Application and Attestation Content
  • Ongoing Monitoring of Sanctions

With well-known clients including athenahealth, 1199 SEIU, and Independence Care Systems on their side, CredSimple is proving that this “outside-the-box, inside-the-framework” methodology is a powerful pathway to market transformation. The high cost of healthcare administration, an explosion of non-traditional care models, and recent costly data-management mistakes by top healthcare players, are proof that the healthcare industry needs new solutions that allow companies to be agile and run a business that’s responsive to industry changes.

About CredSimple

CredSimple provides an easily operated credentialing platform for healthcare organizations of all shapes and sizes. Using CredSimple allows healthcare organizations to credential providers and facilities in one secure place. Founded in 2013 by Michael Simmons andSam Meyer, CredSimple cuts the credentialing process down from the typical three month period to a matter of days. With just a few clicks, organizations can monitor and maintain data quality and freshness in real time. CredSimple reduces the administrative burden of current provider data management practices and ensures a positive impact on operations across the organization. Working closely with healthcare regulatory organizations like NCQA, Joint Commission and CMS, CredSimple ensures compliance with credentialing guidelines. For more information head to

About NCQA

NCQA is a private, non-profit organization dedicated to improving healthcare quality. NCQA accredits and certifies a wide range of healthcare organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in healthcare. NCQA’s Web site ( contains information to help consumers, employers and others make more informed healthcare choices.

SOURCE CredSimple

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