OC Certification Statuses

OC Certification Statuses

An Organization can earn the following NCQA Certification status levels based on their performance against NCQA's Standards and Guidelines:

Certification:  NCQA awards certification to an organization that demonstrates substantial performance within each standard category.

Denial of Certification:  A denied status occurs when the organization significantly fails to comply with the requirements within a chosen evaluation option of the OC program. Denial of Certification may also occur if NCQA determines that a particular identified deficiency poses a potential risk to the health and safety of members.


UM/CR Report Card

View the Utilization Management/Credentialing Certification Report Card.

NCQA Policy Support

  • FAQs

    New FAQs are posted on the 15th of every month and provide answers to our most commonly asked questions.

  • Policy Clarification Support (PCS)

    If you cannot find an answer to your question in our FAQs or Policy Updates, submit your inquiry here.

  • Policy Updates & Supporting Documents

    Policy updates and supporting documents include important notifications regarding NCQA's Accreditation and Certification programs, as well as HEDIS measures.

© Copyright 2010, NCQA. All Rights Reserved.
National Committee for Quality Assurance     1100 13th Street, NW, Suite 1000, Washington, DC 20005
Telephone: 202/955-3500 | Fax: 202/955-3599 | Customer Support: 888/275-7585