FAQ Directory

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 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, 2019

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, 2020

8.24.2018 How do I get started with Health Plan 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:
HP 2017, 2018, 2019, 2020

8.24.2018 Are there any other documents or information that will help me get started with Accreditation/Certification?

This applies to the following Programs and Years:
WHP 2014, Cert|2014 WHP|2016 WHP|Cert 2016

8.24.2018 How do we start?

If you do not currently have Physician and Hospital Quality Certification and are interested in learning more, contact NCQA. If you have a current certification and want to talk to someone about current status or about renewing, submit a question through My NCQA.

This applies to the following Programs and Years:

8.24.2018 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.

This applies to the following Programs and Years:
UM-CR 2017|UM-CR-PN 2018, 2019

8.24.2018 Are there additional resources for case management organizations seeking LTSS Distinction?

  • LTSS Best Practices Academy: Interactive forum for professionals to discuss strategies for coordinating quality long-term services and supports (LTSS) programs.
  • LTSS Roadmap: A compilation of resources to guide organizations through meeting Case Management and Health Plan Standards for LTSS.

This applies to the following Programs and Years:
CM 2017

8.24.2018 Where can I find the Medicaid Module Standards and Guidelines? How can I obtain the Medicaid Module Standards and Guidelines?

Submit your request for the 2018 Medicaid Module at My NCQA.

This applies to the following Programs and Years:
HP 2018, 2019, 2020

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, 2020

8.24.2018 Where can I find information to help me get started with the Medicaid Module?

This applies to the following Programs and Years:
HP 2018, 2019, 2020

8.24.2018 How do I get started with the Medicaid Module?

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:
HP 2018, 2019, 2020

8.24.2018 Where can I find information to help me get started with Provider Network Accreditation?

This applies to the following Programs and Years:
UM-CR-PN 2018, 2019