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 How do I get started with LTSS Distinction for Health Plans?

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 Where can I find information to help me get started with Utilization Management Accreditation?

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

8.24.2018 Where can I find information to help me get started with LTSS Distinction for Case Management Organizations?

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

This applies to the following Programs and Years:
MBHO 2017, 2018, 2019

8.24.2018 What is the process for meeting Module requirements?

The first step 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 provides results within 30 days of the final review.

See a step-by-step process.

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

8.24.2018 How do we earn Physician and Hospital Quality Certification?

Organizations must go through a survey and submit documentation to NCQA. The survey score determines certification. See a step-by-step process.

This applies to the following Programs and Years:

8.24.2018 Where can I find information to help me get started with Health Plan Accreditation?

This applies to the following Programs and Years:
HP 2017, 2018, 2019, 2020

8.24.2018 What is CVO Certification?

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.

This applies to the following Programs and Years:
CVO 2016

8.24.2018 How does Accreditation/Certification help my organization?

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.

 

This applies to the following Programs and Years:
WHP 2014, Cert, 2016, Cert|2013 WHP|Cert 2014|2016 WHP

8.24.2018 How does Provider Network Accreditation help my organization?

Use the NCQA Provider Network Accreditation standards to perform a gap analysis and determine improvement areas. The standards provide a framework for implementing industry best practices to:

  • Improve operational efficiencies.
    • Consistent monitoring of practitioner availability and accessibility of services.
    • Efficient collection and analysis of member-experience data.
    • Appropriate credentialing of practitioners and providers.
  • Elevate your organization’s reputation. Accreditation demonstrates that your organization has the processes and procedures to provide effective network management services.
  • Align with state requirements. Use accreditation standards to improve your internal operations and align with state requirements.
  • Improve contracting opportunities. Ability to reduce administrative responsibility for NCQA-Accredited organizations that delegate network management and credentialing activities.
 

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

8.24.2018 What is the price for Wellness and Health Promotion Accreditation/Certification?

Pricing is based on multiple factors. Full pricing information can be obtained by submitting a request through My NCQA.

This applies to the following Programs and Years:
WHP 2014, Cert, 2016, Cert|2013 WHP|Cert 2014|2016 WHP