What Payers Really Need to Know About NCQA’s Credentialing Guideline Updates Written By Cristina Stahr Share this On July 1, 2025, the updated National Center for Quality Assurance (NCQA) credentialing standards went into effect after much anticipation from payers across the country. These updated standards will raise the bar for payers’ credentialing processes, requiring higher standards for provider data and more oversight of provider eligibility between credentialing cycles. If you haven’t read the hundreds of pages documenting these changes, you’re not alone. The good news is that Donna Thiel, ProviderTrust’s Chief Compliance Officer, has scoured the document and spoken with NCQA leaders to understand what these changes mean for the industry. These new standards significantly impact the way most payers approach credentialing, and we’re here to help you unpack what they mean. Here, we’ve highlighted the key areas that affect payers across the country as they adapt to the new standards. While this may be a difficult transition for many payers, the new standards will ultimately uphold NCQA’s mission to improve the quality of healthcare. For ProviderTrust clients, the new standards closely mirror the best practices we’ve recommended for years. These standards may be difficult for the average payer to meet, but at ProviderTrust, we’ve gone above and beyond these standards for years.
