Introducing Flags: Stay Ahead of Credentialing Risks with Alerts

Credentialing in healthcare is a complex yet critical process. Current credentialing specialists are tasked with doing more, faster, and with greater accuracy than ever before. Regulatory demands are increasing, posing a risk of exposure to fines that can ensue when credentials lapse.

Mistakes are not merely inconvenient—they’re costly. They expose health plans to liability, risk patient safety, and jeopardize compliance with national standards. As of July 1, 2025, the bar was raised even higher. That’s when the National Committee for Quality Assurance (NCQA) officially transitions from its Credentials Verification Organization certification to a more rigorous framework: the Accreditation and Certification in Credentialing and Provider Network (CRPN) program.

At Certify, we know what this change means for your workflows, and we’re here to help. That’s why we’re launching Flags, a powerful new feature designed to make credential monitoring smarter, faster, and more proactive than ever before.

New NCQA Requirements: What You Need to Know

The CRPN program introduces significant changes to how credentialing must be conducted, particularly in terms of monitoring and evaluation. The most notable new requirement mandates that health plans:

• Continuously monitor practitioner state licenses
• Update license data at least every 30 days
• Regularly review and act on expired or lapsed credentials

These changes mean that static systems, manual spreadsheets, and periodic audits will no longer suffice; compliance now demands continuous credential surveillance and timely action.

Without the appropriate tools, these requirements present a significant risk. But with Certify’s new Flags feature, you can transform compliance into confidence—and chaos into clarity.

What Is Flags?

Flags is a dynamic credential monitoring alert system now built into Certify’s platform. It automatically surfaces issues across your entire network of practitioners, so your team always knows where attention is needed.

With the Flags Page and its central “Items to Review” feature, you gain immediate visibility into credentials that require action. Whether it’s an approaching expiration date, a newly inactive license, or a compliance anomaly, Flags ensures you see—and respond to—issues before they become problems.

With this centralized dashboard, users can quickly review flagged credentials, prioritize by severity, and take appropriate next steps—all in one place.

Flags Transforms Credential Monitoring

Credentialing professionals are stretched thin. Manual checks, scattered files, and complex regulatory updates make it difficult to maintain compliance, let alone achieve operational efficiency. Flags was designed to solve exactly these problems.

What Flags does for your team:

• 95% Reduction in Missed Expirations. Automated alerts for upcoming credential expirations. With real-time tracking, your team won’t be caught off guard by a lapsed license ever again.
• 60% Decrease in Manual Monitoring Time. By automating the credential surveillance process, Flags significantly reduces the need for manual checks. Free up your team’s time to focus on high-value tasks instead of tedious data verification.
• 6x Faster Issue Resolution. Alerts are automatically routed to the right users, allowing for issue prioritization by urgency. The result? Faster decisions, quicker resolutions, and more agile operations.
• Reduced Liability and Better Audit Readiness. Every action taken through the Flags dashboard is tracked and time-stamped, creating a secure audit trail. When regulators come knocking, you’ll be ready, with documented proof of compliance at your fingertips.
• Seamless Integration—No Setup Required. Flags will be automatically enabled in all Certify subscriber dashboards. There’s no need for manual configuration or additional integration work. As soon as the feature goes live, you’ll see the Flags tab on your dashboard, populated with real-time alerts relevant to your practitioner network.

"I waited three years for a monitoring dashboard from our previous vendor and they couldn't deliver—that was my tipping point. Monitoring 25,000 providers takes me eight hours of just filtering. Having a dashboard from Certify that lets me review each provider in an effective process, without showing all the stuff I don't need to see, makes my life easier and allows me to get more work done."

- Jeff Morris, Credentialing Manager, Rula

If you have questions about using the new Flags feature or need support, check out our suite of how-to videos found in our knowledge base or book a quick demo with our sales team.

Designed for the Future of Credentialing

This new feature is a step toward a smarter, more automated future for credentialing.

At Certify, we’re on a mission to become the single source of truth for healthcare provider data. That means delivering real-time insights, seamless integrations, and continuous enhancements that empower healthcare organizations to meet regulatory demands without the manual burden.

Flags is a reflection of our commitment to that vision. By embedding real-time alerts directly into your workflow, we’re not just helping you meet NCQA’s new requirements—we’re helping you build a more resilient, efficient, and compliant credentialing operation.

And this is only the beginning. Stay tuned for further enhancements in the coming months as we continue to refine and improve our monitoring tools to meet the evolving needs of the healthcare industry.