FAQ Directory

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:

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.

This applies to the following Programs and Years:

Organizations that have earned NCQA LTSS Distinction can be found in the NCQA Report Card.

This applies to the following Programs and Years:

CVO Certification assesses an organization’s performance in the following requirement areas:

• Internal Quality Improvement Process
• Protecting Credentialing Information
• Verifying credentials.

NCQA’s CVO Certification program offers the following 11 certification options:

This applies to the following Programs and Years:

An organization is eligible for the NCQA LTSS Distinction if:

• It has a current NCQA Accreditation status, or
• Is seeking NCQA Case Management Accreditation.

Note:  NCQA conducts LTSS Distinction Surveys at the legal-entity level.
 

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 Health Plan Accreditation standards to perform a gap analysis and determine improvement areas. They provide a framework for implementing evidence-based, best practices help plans improve in areas of:
  • QI process.
  • Population health management.
  • Practitioner network and access to care.
  • Utilization management processes.
  • Credentialing and recredentialing processes.
  • Members’ rights and responsibilities.
  • Member connection.
  • Medicaid service requirements.
• Satisfy state requirements and employer needs. The standards align with many state requirements.

This applies to the following Programs and Years:

Over 1,000 health plan products have earned NCQA Health Plan Accreditation. See the NCQA Report Card for a directory of accredited organizations.

This applies to the following Programs and Years:

Any organization that provides wellness and health promotion services can apply for accreditation/certification if it:

• Provides wellness services, either directly or through a service agreement, and
• Provides wellness services for at least three months before survey submission, and 
• Has a process for monitoring, evaluating and improving the quality and safety of services provided to eligible participants.

This applies to the following Programs and Years:

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

This applies to the following Programs and Years:

• Managed Behavioral Healthcare Organization Accreditation:
  • Provides a framework for internal quality improvement in:
  • Quality Management and Improvement.
  • Care Coordination.
  • Utilization Management.
  • Credentialing and Recredentialing.
  • Members’ Rights and Responsibilities.
• Elevates your organization’s status in the marketplace.
• Improves contracting opportunities.
• Satisfies health plan requirements.

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: