FAQ Directory

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:

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:

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:

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:

Find the Standards and Guidelines document in the NCQA eStore.

This applies to the following Programs and Years:

Use the NCQA Case Management Accreditation standards to perform a gap analysis and determine improvement areas. They provide a framework for implementing evidence-based best practices to ensure:

• Efficient and cost-effective case management processes and service delivery.

• Apply a QI process to improve operations.
• Maintain security of personal health information.
• Ensure patient access to well-qualified case management staff.
• Develop personalized, patient-centered care plans.
• Manage patients between care settings.
• Conduct systematic patient-centered assessments.
• Monitor patient to care goals progress.

This applies to the following Programs and Years:

Case Management Accreditation is for organizations that provide a broad range of case management services for complex and high-risk populations. Organizations are eligible if it:

• Provides case management services for at least 6 months.
• Delivers a broad range of case management services for complex or high-risk populations.
• Perform functions covered in the accreditation program or arrange for the functions to be performed, directly or through a service agreement.

Manage valid sample size of individuals for NCQA evaluation, where standards require patient file review.

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:

Earning NCQA’s 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 needs of states and MCOs. NCQA-Accredited organizations demonstrate that they’re ready to be trusted partners in coordinating LTSS services.

This applies to the following Programs and Years:

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:

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

• Identification and assessment
• Care planning
• Care monitoring
• Care transitions
• Measurement and quality improvement

This applies to the following Programs and Years:

More than forty organizations have earned NCQA Credentialing Accreditation. See the NCQA Report Card for a directory of accredited organizations.

This applies to the following Programs and Years: