FAQ Directory

In general, any organization that operates a physician measurement program or hospital transparency program is eligible for certification. This includes, but is not limited to:

• Health plans.
• Provider networks.
• Collaborative measurement organizations.
• Information providers.

Organizations that meet these criteria are also eligible:

• Operate a physician measurement program or hospital transparency program, as defined in the standards.
• Are responsible for responding to complaints from consumers and to requests for change from physicians or hospitals based on the organization’s actions.
• Comply with applicable federal, state and local laws and regulations, including requirements for licensure.
• Operate without discrimination based on sex, race, creed or national origin.

Note: There are other eligibility criteria. Refer to the standards and guidelines document available in the NCQA eStore.

This applies to the following Programs and Years:

Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.

This applies to the following Programs and Years:

The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.

This applies to the following Programs and Years:

An organization is eligible for the NCQA Health Plan Medicaid Module if:

• Its Medicaid product line has a current NCQA Accreditation status as a First or Renewal Survey, or
• It is seeking accreditation for its Medicaid product line under NCQA HP Accreditation as an Interim, First or Renewal Survey.

This applies to the following Programs and Years:

Find the Standards and Guidelines document in the NCQA eStore.

This applies to the following Programs and Years:

Earning NCQA Accreditation of Case Management for LTSS can help organizations:

• Become more efficient. A focus on coordinated care, training and measurement can help organizations reduce errors and duplicated services.
• Integrate care better. Standards can help organizations improve communication between individuals, caregivers, providers, payers and other organizations that coordinate care.
• Provide person-centered care. Standards focus on person-centered services, which can lead to better care planning and monitoring.
• Support contracting needs. Standards align with the state needs. NCQA-Accredited organizations demonstrate that they’re ready to be trusted partners in coordinating LTSS services.

This applies to the following Programs and Years:

This applies to the following Programs and Years:

Find the Standards and Guidelines document in the NCQA eStore.

This applies to the following Programs and Years:

The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.

This applies to the following Programs and Years:

Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.

This applies to the following Programs and Years:

NCQA Credentialing Accreditation is a comprehensive program that evaluates the operations of organizations providing full-scope credentialing services, which include verifying practitioner credentials, designated credentialing-committee review of practitioners and monitoring practitioner sanctions.

This applies to the following Programs and Years:

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: