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 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 What is the process for earning LTSS Distinction for Health Plans?

The first step to earning distinction 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 distinction 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 What is the process for earning LTSS Distinction for Case Management Organizations?

The first step to earning distinction 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 distinction status within 30 days of the final review.

See a step-by-step process.

This applies to the following Programs and Years:
CM 2017

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