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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 long does it take to earn LTSS Distinction for Case Management Organizations?

The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.

CM 2017

8.24.2018 What other organizations have earned Utilization Management Accreditation?

More than 50 organizations have earned NCQA Utilization Management Accreditation. See the NCQA Report Card for a directory of accredited organizations.

UM-CR

8.24.2018 How long does it take to earn LTSS Distinction for Health Plans?

The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.

HP 2020

8.24.2018 What other organizations have earned Provider Network Accreditation?

Several organizations have earned NCQA Provider Network Accreditation. See the NCQA Report Card for a directory of accredited organizations.

UM-CR-PN 2019

8.24.2018 Where can I find the LTSS Distinction Standards and Guidelines?

8.24.2018 How long does it take to earn Provider Network Accreditation?

The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.

UM-CR-PN 2019

8.23.2018 Where can I find information to help me get started with Credentialing Accreditation?

8.23.2018 What is the process for earning Credentialing 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 CR standards. NCQA conducts the survey and determines your accreditation status within 30 days of the final review.

See a step-by-step process.

UM-CR 2016

8.23.2018 How do I get started with Credentialing 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.

UM-CR 2016

8.23.2018 How long does it take to earn Credentialing Accreditation?

The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.

UM-CR 2016

8.23.2018 What organizations are eligible for Credentialing Accreditation?

Credentialing Accreditation is for organizations that provide full scope credentialing services. Eligible organizations:

  • Must not be licensed as an HMO, POS, PPO or EPO.
  • Must not be eligible for NCQA Accreditation as a health plan or an MBHO.
  • Must perform credentialing functions directly or through a contract.
  • Must perform credentialing activities for at least 50% of a practitioner network.

Note: A “practitioner network” is the practitioner network of clients and organizations.

UM-CR 2016

8.23.2018 What is the price for Credentialing Accreditation?

Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.

UM-CR 2016