The Standards and Guidelines document can be found in the NCQA eStore.
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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The Standards and Guidelines document can be found in the NCQA eStore.
NCQA LTSS Distinction for Case Management Organizations is a complementary program designed to support organizations that provide comprehensive clinical case management services and coordinate social services for LTSS populations. The program standards provide a framework for organizations to deliver efficient, effective person-centered care that meets people’s needs, helps keep people in their preferred setting and aligns with state requirements.
NCQA CVO Certification is designed to ensure organizations can maintain a high-quality network for members and contracted clients. The standards provide a framework for adopting industry best practices to promote accurate and efficient verification of practitioner credentials—ensuring that medical organizations employ qualified professionals and align with state requirements.
NCQA CVO Certification evaluates the operations of organizations that verify practitioner credentials. Verification is accomplished through the primary source, through a recognized source or through a contracted agent of the primary source.
NCQA Wellness and Health Promotion Accreditation/Certification evaluates full and limited scope wellness program performance against the standards. Programs should appropriately address implementing a workplace program, protecting private health information and empowering participants to improve their health.
The typical evaluation timeframe, from application submission to decision, is 12 months. This depends on the organization’s readiness, as some organizations may already be working within NCQA guidelines.
| NCQA Wellness and Health Promotion Accreditation/Certification focuses on services most desired by employers and health plans as well as expected by consumers. It provides a framework for organizations to implement industry best practices and apply evidence-based methods proven to support health and improve outcomes.
The standards help health and wellness organizations identify gaps for improvement and align their services with those desired by potential contracting organizations. |
Find the Standards and Guidelines document in the NCQA eStore.