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Here are some of the most frequently asked questions about NCQA’s various programs. If you don’t see what you are looking for in one of the entries below, you can ask a question through My NCQA.
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8.24.2018 Where can I find the Medicaid Module Standards and Guidelines? How can I obtain the Medicaid Module Standards and Guidelines?
8.24.2018 What is the process for earning Health Plan Accreditation?
The first step to earning accreditation is a discussion with an NCQA program expert. Purchase and review the program resources, conduct a gap analysis and submit your online application.
Align your organization’s processes with the standards. NCQA conducts the survey and determines your accreditation status within 30 days of the final review.
See a step-by-step process.
This applies to the following Programs and Years:
HP 2017, 2018, 2019, 20208.24.2018 Where can I find information to help me get started with the Medicaid Module?
- Accreditation Process and Timeline: Key steps, timing and resources for a successful accreditation.
- Standards and Guidelines: The complete standards and guidelines, including the intent and scope of review.
- Interactive Survey Tool: Contains the complete standards and guidelines; you can also determine your organization’s survey readiness—the tool calculates your potential survey score.
This applies to the following Programs and Years:
HP 2018, 2019, 20208.24.2018 How do I get started with Provider Network Accreditation?
If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.
This applies to the following Programs and Years:
UM-CR-PN 2018, 20198.24.2018 Are there any other documents or information that will help me get started with Accreditation/Certification?
- Accreditation/Certification Process and Timeline: identifies key steps, timing and resources to successfully seek Certification.
- Standards and Guidelines: provides the comprehensive descriptions of the standards, including the intent and the scope of review.
- Interactive Survey Tool: includes the complete standards and guidelines and allows your organization to determine its readiness for a survey by responding to each standard. The tool calculates your survey score.
This applies to the following Programs and Years:
WHP 2014, Cert|2014 WHP|2016 WHP|Cert 20168.24.2018 How long does it take to earn Physician and Hospital Quality Certification?
8.24.2018 What is the process for earning Provider Network Accreditation?
| The first step to earning accreditation is a discussion with an NCQA program expert. Purchase and review the program resources, conduct a gap analysis and submit your online application.
Align your organization’s processes with the Provider Network standards. NCQA conducts the survey and determines your accreditation status within 30 days of the final review. |
See a step-by-step process.
This applies to the following Programs and Years:
UM-CR-PN 2018, 20198.24.2018 What does Physician and Hospital Quality Certification cost?
Price varies by organization and is based on number of physicians and number of programs. Contact NCQA for pricing information.
This applies to the following Programs and Years:
8.24.2018 What organizations are eligible for the LTSS Distinction for Health Plans? What organizations are eligible?
An organization is eligible for the NCQA LTSS Distinction for a product/product line if:
- The product/product line has a current NCQA Accreditation status, or
- The product/product line is seeking NCQA Health Plan Accreditation.
Note: NCQA conducts LTSS Distinction Surveys at the legal-entity level. Organizations undergoing Interim Survey are not eligible for LTSS distinction.
Health plans that coordinate LTSS and do not provide medical or behavioral services are not eligible for this distinction but can earn Accreditation of Case Management for LTSS.
This applies to the following Programs and Years:
HP 2017, 2018, 2019, 20208.24.2018 How do I get started with Wellness and Health Promotion Accreditation/Certification?
If you are not currently Accredited or Certified and are interested in learning more, contact NCQA. If you are currently Certified and want to talk to someone about your current status, renewing or adding Certifications, submit a question through My NCQA.
This applies to the following Programs and Years:
WHP 2016, Cert8.24.2018 Where can I find information to help me get started with Provider Network Accreditation?
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This applies to the following Programs and Years:
UM-CR-PN 2018, 20198.24.2018 How do I get started with Utilization Management Accreditation?
If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.
