It’s an unnerving thought that some credential documents may be forged and fake. The consequences of a practicing illegitimate doctor will affect the surgery center and most importantly, the patients’ safety. To ensure that facilities only grant privileges to skilled and experienced physicians with legitimate credentials, primary source verification must be completed through acceptable sources.
In an earlier article, we introduced primary source verification and the organizations that qualify as primary sources. Accreditation organizations such as The Joint Commission and AAAHC also accept what are called “designated equivalent sources” for verification purposes for education and training. There are 4 commonly accepted designated equivalent sources:
- The American Medical Association (AMA) Physician Masterfile
- The American Board of Medical Specialties (ABMS)
- The Educational Commission for Foreign Medical Graduates (ECFMG)
- The American Osteopathic Association (AOA) Physician Database
In the following sections, we will be exploring each designated equivalent source and how to use them to verify a physician’s credential.
The American Medical Association (AMA) Physician Masterfile
As the nation’s largest depository of primary physician data, the American Medical Association collects, maintains, and disseminates primary source physician data. It continuously collects and updates information giving it a large role in health information management.
The AMA Physician Masterfile, also referred to as the full physician profile, can be used by facilities to confirm credentials of Physicians who are applying for initial privileges or reappointment. It is accepted for the primary source verification of a physician’s U.S. and Puerto Rican medical school graduation and postgraduate residency completion.
The profile is a downloadable and printable document that can be accessed after ordering from AMA website for $39 per profile. Each AMA profile includes the following information:
- Mailing address
- Primary office address
- Primary office phone number
- Date of birth
- Self-designated specialty
- AMA member status
- National provider identifier (NPI) number
- Medical education information
- Post-graduate medical school information
- NBME certification
- State licensure information
- ECFMG application number, if applicable
- DEA registration number
- Specialty board certification
- Sanction information
To use the AMA Physician Masterfile for primary source verification, you must include a recently updated and printed version in the credential file. The document should have the access date clearly printed.
AMA verification is accepted by: The Joint Commission, CMS, HFAP, DNV-GL, and AAAHC.
The American Board of Medical Specialties (ABMS)
The American Board of Medical Specialties is a non-profit organization that sets professional and educational standards for medical specialty and certifications to maintain quality healthcare. It is a nationally-recognized repository of certifications information that can be used to verify a physician’s board certification status.
The ABMS Solutions CertiFacts Online is widely accepted for the primary source verification of a physician’s board certification. With a 1-2 year subscription that allows unlimited verifications, credential managers are able to search and retrieve physician certification data quickly and securely. The query reports include:
- Effective and expiration dates of certification
- A complete certification history
- Date stamps
To use ABMS for primary source verification, you must include a date-stamped printout in the credential file.
AMBS verification is accepted by: The Joint Commission, the National Committee for Quality Assurance, and URAC.
The Educational Commission for Foreign Medical Graduates (ECFMG)
Did you know that international medical students make up 25% of the world’s physician workforce? The ECFMG is an internationally-recognized organization that evaluates the qualifications of international medical students and schools. All international medical students are required to have the ECFMG Certification in order to practice in the United States.
The ECFMG is accepted as a primary source because it completes the primary source verification itself. After receiving a credential from a medical school, the ECFMG confirms that it is a legitimate credential in correct format after comparing it to the credentials in its Medical Credentials Reference Library. ECFMG will then contact the medical school to verify the credential in the language of the country that the school is located in. Once completed, the applicant is eligible for the ECFMG Certification program.
The Certification Verification Report is available for download after paying a fee of $35 through their website. To use ECFMG for primary source verification, you must include the ECFMG Certificate Verification in the credential file.
ECFMG verification is accepted by The Joint Commission.
The American Osteopathic Association (AOA) Physician Database
The American Osteopathic Association is the primary certifying body for osteopathic physicians (DOs) as well as the main accrediting body for osteopathic schools, hospitals, and facilities. It collects and maintains primary source information of osteopathic physicians in its physician database.
The Official Osteopathic Physician File Report is accepted as primary source verification for predoctoral education accredited by the AOA Bureau of Professional Education, postdoctoral education approved by the AOA Council, and Osteopathic Specialty Board Certifications. It contains the following up-to-date information:
- AOA accredited/approved pre- and postdoctoral education and training dates of attendance and completion
- All state licenses held with expiration dates
- Osteopathic Specialty Board Certification(s) expiration dates and participation in OCC
- Certification by member board(s) of the ABMS and participation in MOC
- AOA accredited CME status
- DEA status
- State and federal sanction alerts
- Former names
The AOA Physician Database for primary source verification, you must purchase a Physician File Report through the online site for $20 per report and include the report in the credential file.
The Official Osteopathic Physician File Report is accepted by: the AOA Healthcare Facilities Accreditation Program; TJC; NCQA; URAC; and the NAIC.
Verification is a multistep process that cannot be omitted. Find out how Silversheet’s AMA Profile integration can eliminate extra steps in your credentialing workflow!