With NCQA tightening provider credentialing and monitoring standards on July 1, 2025, healthcare organizations must ensure compliance with the updated license verification and proactive monitoring timelines. Manual tracking increases the risk of compliance gaps, penalties and accreditation delays.
This quick-reference checklist outlines the five essential steps to meet NCQA’s new requirements. Download a copy of the checklist here.
1. Centralize data
Conduct an internal audit of current licensure records. Consolidate data into a single source of truth for better visibility.
2. Automate verifications
Implement AI-driven monitoring tools for real-time compliance, and set up automated alerts for expiring credentials.
3. Rapid responsiveness
Create a workflow for addressing expirations within NCQA’s 30-day window, and assign clear roles and responsibilities within compliance teams.
4. Train team
Provide ongoing training sessions to keep teams informed. Schedule quarterly refreshers to maintain compliance alignment.
5. Use AI-powered credentialing
For continuous compliance, monitor provider licenses in real time to avoid lapses. Ensure workflows stay up-to-date to keep ahead of regulatory changes.
Stay NCQA-ready with Medallion
Ensure seamless compliance and risk-free credentialing with automated, real-time license monitoring. Get in touch with our team of experts to learn how Medallion can help you stay ahead of ever-changing compliance standards.