Primary source verification is the process of confirming a provider’s credentials directly with the organization that issued them, instead of relying on copies, a CV, or the provider’s own statements. It is a core requirement of payer and hospital credentialing and a main reason the process takes weeks.
What Gets Verified
- State medical license, checked with the issuing state board
- Education and residency or fellowship training, confirmed with the school or program
- Board certification, confirmed with the specialty board
- DEA registration, checked with the DEA
- Work history and any gaps, confirmed with prior employers
- Malpractice claims history and National Practitioner Data Bank results
- Sanction and exclusion lists, such as the OIG exclusion list
Each check depends on someone else’s response time. Boards and schools answer on their own schedules, and prior employers can take weeks to return a work history. Providers cannot speed those responses up, but they can avoid delays by listing exact dates, using names that match across every document, and replying quickly when a credentialing specialist asks for a missing item. Verification software shortens some checks, a trend covered in How Technology is Fixing Primary Source Verification. For the full timeline picture, see how long medical credentialing takes.