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.
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 Provider Network Accreditation?
8.24.2018 What organizations are eligible for the Medicaid Module?
An organization is eligible for the NCQA Health Plan Medicaid Module if:
- Its Medicaid product line has a current NCQA Accreditation status as a First or Renewal Survey, or
- It is seeking accreditation for its Medicaid product line under NCQA HP Accreditation as an Interim, First or Renewal Survey.
This applies to the following Programs and Years:
HP 2018, 2019, 20208.24.2018 What is Long-term Services and Supports Distinction for Health Plans?
NCQA LTSS Distinction for Health Plans is a complementary program designed to support health plans coordinating 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 requirements.
This applies to the following Programs and Years:
HP 2017, 2018, 2019, 20208.24.2018 What other health plans have earned LTSS Distinction?
Organizations that have earned NCQA LTSS Distinction can be found in the NCQA Report Card.
This applies to the following Programs and Years:
HP 2017, 2018, 2019, 20208.24.2018 Where can I find the Accreditation/Certification Standards and Guidelines?
The Standards and Guidelines document can be found in the NCQA eStore.
This applies to the following Programs and Years:
WHP 2014, Cert|2014 WHP|2016 WHP|Cert 20168.24.2018 What is the price for the LTSS Distinction for Health Plans?
8.24.2018 Where can I find the Provider Network Standards and Guidelines?
Find the Standards and Guidelines document in the NCQA eStore.
This applies to the following Programs and Years:
UM-CR-PN 2018, 20198.24.2018 What organizations are eligible for Provider Network Accreditation?
To be eligible for Provider Network Accreditation, an organization must:
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Note: A “practitioner network” is the practitioner network of clients and organizations.
This applies to the following Programs and Years:
UM-CR-PN 2018, 20198.23.2018 How long does it take to earn Credentialing Accreditation?
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.
This applies to the following Programs and Years:
UM-CR 2017, 2016|UM-CR-PN 2018, 20198.23.2018 What are the Credentialing Accreditation requirements?
Credentialing Accreditation assesses an organization’s performance in the following areas:
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This applies to the following Programs and Years:
UM-CR 2017, 2016|UM-CR-PN 2018, 20198.23.2018 Where can I find information to help me get started with Credentialing Accreditation?
- 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.
