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Health Plan Accreditation Virtual Onsite Renewal Survey

NCQA now offers organizations scheduled or applying for a Health Plan Accreditation Renewal survey the opportunity to conduct the entire survey, including file reviews, through a virtual medium. 

As part of the “regular” accreditation survey, NCQA spends two days onsite at a plan conducting file review. In a “virtual” onsite, NCQA surveyors conduct the file review via desktop sharing or Web conferencing software and conference call line. Surveyors do not travel to the plan site.

Survey Process

  • The survey process follows the same timeline as regular surveys.

  • Plans must provide files in a readable electronic format to be presented by the organization to the survey team by Web conferencing/desktop sharing. Examples of formats can include: 

-Files viewable in data systems (e.g. case management systems)
-PDF-scanned documents

  • The plan is responsible for hosting all conference calls and webcasts and must provide technical support during the conference calls and webcasts to handle any issues.

To qualify, the organization’s survey must meet the following conditions: 

  • It must be a renewal survey.
  • The file review portion of the survey must consist of only one file sample and review for each file review category (case management, UM denials, appeals and credentialing/ recredentialing). 
  • The survey must not require more than the standard number of surveyors (one administrative; one physician).

If the plan does not have prior experience undergoing a virtual NCQA survey then staff directly involved in the survey process must view the recorded information session available from the link below in order to participate in a virtual survey.  

After you view the session, you have the option to complete a brief survey to provide your name and some other additional information so we know that you have completed the requirement.

The session is approximately 15 minutes long. It may take a few minutes to load the buffer, depending on your internet connection.

To request a virtual onsite, please complete the applicable section in the Application for Survey packet. NCQA will contact you as part of the application review process to determine your eligibility and inform you if the request is approved. If you have general questions about the virtual onsite process, submit them to NCQA’s Policy Clarification and Support (PCS) system.

Click here to start the information session.