FAQ Directory

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.

This applies to the following Programs and Years:

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.

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:

Find the Standards and Guidelines document in the NCQA eStore.

This applies to the following Programs and Years:

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

This applies to the following Programs and Years:

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.

This applies to the following Programs and Years:

More than 90 organizations have earned NCQA Credentialing Accreditation. See the NCQA Report Card for a directory of accredited organizations.

This applies to the following Programs and Years:

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.

This applies to the following Programs and Years:

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.

This applies to the following Programs and Years:

• 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.

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:

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.

This applies to the following Programs and Years: