Health Information Products (HIP) Certification

HIPgeneralRGBlowres.jpgThe health information products (HIP) certification program highlights organizations that provide a variety of services, including health information lines, pharmacy benefits information and online physician and hospital directories. NCQA-Accredited health plans receive automatic credit (i.e., 100% compliance) toward their own Accreditation Survey when they work with certified HIP vendors. The result is a streamlined survey process and more productive ties between high-performing organizations.

HIP Certification Options

NCQA’s HIP Certification program evaluates specific functions of organizations that provide health information products. Organizations may choose to be evaluated in one or more “Certification Options”. Each option is specific to one of the certification functions.

An organization may seek certification in any or all of the following evaluation options:

  • Pharmacy Benefit Information (HIP 1)— The organization provides eligible individuals with the information they need to understand and use their pharmacy benefits.
  • Health Information Line (HIP 2)— The organization has a health information line to assist eligible individuals with wellness and prevention.
  • Support for Healthy Living (HIP 3)— The organization provides access to wellness and prevention services.
  • Physician and Hospital Directories (HIP 4)— The organization provides information to help eligible individuals choose physicians and hospitals.

What Certification Levels Can a HIP Organization Achieve?

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, in NCQA’s judgment, substantial performance against the requirements within the chosen certification options.

In-Depth HIP Certification Information

Certification Levels and Evaluation Options

Survey Support

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Fact Sheet

Attention: Customers Renewing HIP Certification

If you are an organization that currently holds NCQA HIP Certification and has a renewal survey scheduled on the 2014 standards (between July 1, 2014 and June 30, 2015), click here for information about changes for 2014.
 

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HIP Report Card

Click here to view the Health Information Products report card.

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.