FAQ Directory

More than 90 organizations have earned CVO Certification. A directory of Certified organizations can be found at the NCQA Report Card.

CVO

Any organization that provides managed health care services may apply for the NCQA Managed Behavioral Healthcare Organization Accreditation if it meets the following criteria:

• Has been in operation for at least six months, and
• Enrolls or receives enrollment of an identifiable eligible population that is eligible to access the network, and
• Provides comprehensive behavioral health care services through an organized delivery system across a continuum of care, and
• Performs functions addressed in the standards (quality improvement, care coordination, utilization management, credentialing, member rights and responsibilities), either directly or through a service agreement, and
• Has a process for monitoring, evaluating and improving the quality and safety of care.

MBHO 2019

Utilization Management Accreditation assesses an organization’s performance in the following areas:

UM-CR 2019

Find the Standards and Guidelines document in the NCQA eStore.

MBHO 2019

NCQA Utilization Management Accreditation is designed to ensure that organizations pursuing accreditation can deliver fair and timely determinations to get the proper care to patients while effectively managing resources. The standards provide a framework for adopting industry best practices to objectively and efficiently evaluate the appropriateness of requested health care services.

UM-CR 2013

• Managed Behavioral Healthcare Organization Accreditation:
  • Provides a framework for internal quality improvement in:
  • Quality Management and Improvement.
  • Care Coordination.
  • Utilization Management.
  • Credentialing and Recredentialing.
  • Members’ Rights and Responsibilities.
• Elevates your organization’s status in the marketplace.
• Improves contracting opportunities.
• Satisfies health plan requirements.

MBHO 2019

NCQA Utilization Management Accreditation is a comprehensive program that evaluates the operations of organizations providing full-scope utilization management services, which include using evidence-based criteria, relevant clinical information and qualified health professionals to make utilization management decisions.

UM-CR 2013

Over 1,000 health plan products have earned NCQA Health Plan Accreditation. See the NCQA Report Card for a directory of accredited organizations.

HP 2020

NCQA Provider Network Accreditation is a comprehensive, evidence-based program dedicated to quality improvement that evaluates the accessibility and transparency of organization networks and credentialing of practitioners and providers. NCQA-Accredited organizations demonstrate they have the internal processes and procedures to effectively manage access to care and member experience while ensuring that practitioners and providers are appropriately credentialed.

UM-CR-PN 2019

Any organization that provides wellness and health promotion services can apply for accreditation/certification if it:

• Provides wellness services, either directly or through a service agreement, and
• Provides wellness services for at least three months before survey submission, and 
• Has a process for monitoring, evaluating and improving the quality and safety of services provided to eligible participants.

WHP 2013

More than 30 organizations have earned NCQA Health Plan Accreditation. See the NCQA Report Card for a directory of accredited organizations.

MBHO 2019

Find the Standards and Guidelines document in the NCQA eStore.

HP 2020