FAQ Directory

Any organization that provides credentials verification services can apply for Certification if it:

• Verifies practitioner credentials for health plans, MBHOs, physician organizations or health care organizations, and
• Provides verification services for at least six months before application, and 
• Performs verification activities for at least 50% of contracted practitioners, and
• Maintains the necessary credentials documentation, policies and procedures for NCQA to conduct the survey, and
• Obtains errors and omissions insurance for $1M–$2M.

CVO

• Accreditation/Certification Process and Timeline: identifies key steps, timing and resources to successfully seek Certification.
• Standards and Guidelines: provides the comprehensive descriptions of the standards, including the intent and the scope of review.
• Interactive Survey Tool: includes the complete standards and guidelines and allows your organization to determine its readiness for a survey by responding to each standard. The tool calculates your survey score.

WHP 2016

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.

HP 2020

The first step to earning accreditation/certification 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.

WHP 2013

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.

CM 2017

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.

CVO 2016

• Accreditation Process and Timeline: Key steps, timing and resources for a successful accreditation.
• Standards and Guidelines: The complete standards and guidelines, including the intent and scope of review.
• Interactive Survey Tool: Contains the complete standards and guidelines; you can also determine your organization’s survey readiness—the tool calculates your potential survey score.

HP 2020

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.

HP 2020

• 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.

CM 2017

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.

CM 2017

• 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.

HP 2020

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.

HP 2020