Find the Standards and Guidelines document in the NCQA eStore.
UM-CR 2016
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.
Filter Results
- Save
Save your favorite pages and receive notifications whenever they’re updated.
You will be prompted to log in to your NCQA account.
Save your favorite pages and receive notifications whenever they’re updated.
You will be prompted to log in to your NCQA account.
- Email
Share this page with a friend or colleague by Email.
We do not share your information with third parties.
Share this page with a friend or colleague by Email.
We do not share your information with third parties.
- Print
Print this page.
Print this page.
8.23.2018 Where can I find the Standards and Guidelines?
8.23.2018 What are the Credentialing Accreditation requirements?
Credentialing Accreditation assesses an organization’s performance in the following areas:
|
|
UM-CR 2016
8.23.2018 How does Credentialing Accreditation help my organization?
NCQA Credentialing Accreditation is designed to ensure that organizations pursuing accreditation can maintain a high-quality network for members and contracted clients. The standards provide a framework for adopting industry best practices to accurately and efficiently credential and recredential health care professionals—ensuring that medical organizations employ qualified professionals and align with state requirements.
UM-CR 2016
8.23.2018 What other organizations have earned Credentialing Accreditation?
More than 90 organizations have earned NCQA Credentialing Accreditation. See the NCQA Report Card for a directory of accredited organizations.
UM-CR 2016
8.23.2018 What is Credentialing Accreditation?
NCQA Credentialing Accreditation is a comprehensive program that evaluates the operations of organizations providing full-scope credentialing services, which include verifying practitioner credentials, designated credentialing-committee review of practitioners and monitoring practitioner sanctions.
UM-CR 2016
8.22.2018 Eligibility Where can we find more information about PCMH PRIME criteria and documentation requirements?
A list of the 13 PCMH PRIME criteria can be found on the HPC website here. The full PCMH PRIME requirements, including the criteria and all documentation requirements, is available for download at no cost from the NCQA Store.
8.20.2018 Where can I find information to help me get started?
- 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.
CM 2014
8.20.2018 Where can I find the LTSS Accreditation Standards and Guidelines?
Find the Standards and Guidelines document in the NCQA eStore.
CM-LTSS 2017
8.20.2018 What organizations are eligible for Case Management Accreditation?
Case Management Accreditation is for organizations that provide a broad range of case management services for complex and high-risk populations. Organizations are eligible if it:
- Provides case management services for at least 6 months.
- Delivers a broad range of case management services for complex or high-risk populations.
- Perform functions covered in the accreditation program or arrange for the functions to be performed, directly or through a service agreement.
Manage valid sample size of individuals for NCQA evaluation, where standards require patient file review.
CM 2014
8.20.2018 What other organizations have earned Case Management Accreditation?
More than forty organizations have earned NCQA Credentialing Accreditation. See the NCQA Report Card for a directory of accredited organizations.
CM 2014
8.20.2018 What is the price for Case Management Accreditation?
8.20.2018 What is Accreditation of Case Management for LTSS?
NCQA Accreditation of Case Management for LTSS is a comprehensive, program designed to support organizations that coordinate LTSS. 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 and MCO requirements.
CM-LTSS 2017