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UM/CR Program Evaluation Options

NCQA’s UM/CR Certification program requirements assess key aspects of credentialing and utilization management operations. They focus on consumer protection and improvement in service to customers. Organizations may seek certification in either (or both) of the evaluation options.

Credentialing and Recredentialing (CR)

Utilization Management (UM)

 

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UM/CR Report Card

View the Utilization Management/Credentialing Certification Report Card.

 

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HEDIS Users Group (HUG)
HUG membership packages offer you access to the most up-to-date information on HEDIS specifications so you can begin planning for the future.

HEDIS and ICD-10
To accommodate the switch from ICD-9-CM to ICD-10, NCQA created a plan to identify a valid and appropriate set of ICD-10 codes for each HEDIS measure.

Interactive Review Tool (IRT)
Learn more about the IRT Web-based Survey Platform.