Generally hospitals follow a primary source verification process as required by Joint Commission standards and internal processes. Physicians are currently credentialled via these standards and nursing professionals will soon follow (some hospitals already do full credentialling for nurses). The verification can occur a number of ways depending on how much automation the Medical Staff Office has in place. For some verifications such as education they generally send out letters/faxes. Some verifications come via querries to data banks such as queries of the NPDB, OIG and DEA registration. Others are obtained via weblinks such as licensure. As a general rule the medical staff office will only call as a last resort for most verifications -i.e. they cannot obtain a written or automated response. Most have a policy requiring three attempts to obtain a verification. If they can't obtain the verification the contact the applicant. Once the verifications are complete, a credentialling packet is sent to an approval committee. Most MSPs will not forward a packet for approval if any of the required verifications are missing. So although it maybe painful, it is important to make sure the medical staff office has everything they need to verify a credential.