The NCQA’s 2025 standards bring important updates aimed at enhancing the quality and compliance of healthcare services, particularly for payers. These changes emphasize quicker credentialing, improved data reporting, regular license monitoring, and expanded demographic data collection. Below is a checklist highlighting these new requirements and how symplr CVO can support payers in maintaining compliance.
Verification Turnaround
Ensure credentialing is completed in 90 days
Automates credentialing to meet accelerated timelines and avoid backlogs
Reporting and Analytics
Implement audit logs and to track data changes and identify compliance gaps
Provides real-time reporting and
monitoring to ensure no gaps in
information
License Monitoring
Regularly verify provider licenses to track expirations and disciplinary actions
Automates license checks to avoid delays while maintaining accuracy
Enhanced Provider Data Accuracy
Capture race, ethnicity, and language information
Modernized intake and verification process for provider data
