Physician and Hospital Quality Certification Process
Below are process and timeline guidelines for organizations seeking Physician and Hospital Quality Certification. Although the typical evaluation time frame is 9–12 months from submission of the application to decision, it depends on the organization’s readiness—some organizations may already be working within NCQA guidelines.
OVERVIEW DISCUSSION
At least 12 months before your desired survey start date, have a discussion with your NCQA business development representative to:
- Discuss eligibility criteria.
- Review evaluation areas.
- Identify program benefits.
- Review the application process.
If your organization does not have a current certification, contact us today and an NCQA business development representative will be in touch. If your organization has earned NCQA Physician and Hospital Quality Certification and wants to renew, submit a request through My NCQA.
PURCHASE STANDARDS AND SURVEY TOOL
Purchase the standards and guidelines and the survey tool 9–11 months before your desired survey start date, to begin learning the requirements.
The standards and guidelines provide comprehensive descriptions of the requirements. You use the survey tool to upload evidence and submit survey information to NCQA.
SUBMIT THE PREQUALIFICATION FORM
To begin the application process, contact your NCQA business development representative to request a prequalification form. NCQA Reviews the form to determine your organization’s readiness and eligibility.
Provides an online application link, typically within 1–2 business days after receiving the form.
SUBMIT THE ONLINE APPLICATION
Submit the online application and select the desired survey start date. You should submit the application approximately 9 months before you want your survey to start.
An NCQA application scheduling account representative (ASAR) will be available to answer any questions about the application process. When NCQA receives the completed application, the ASAR will contact your organization to finalize the survey start date.
SUBMIT THE SURVEY TOOL
Approximately 3 months before the survey start date, an NCQA accreditation services coordinator will contact your organization to help you understand the survey submission process and answer your questions. Your organization will complete and submit the survey tool on the assigned survey start date, officially starting the survey process.
EARN PHYSICIAN AND HOSPITAL QUALITY CERTIFICATION
An organization’s certification is determined within 90 days of survey submission.
- After the survey, your organization will receive a preliminary report.
- Your organization has 2 weeks to review the report and provide comments and supporting documentation.
- The entire document, including your organization’s feedback, the onsite file review and reviewers’ feedback, will go to the NCQA’s Review Oversight Committee, which considers all the provided information to determine your final score.
RENEW CERTIFICATION
NCQA Physician and Hospital Quality Certification is awarded for two years. Every two years, the organization must complete another agreement, submit all requisite fees and undergo a full survey to renew its status. When the organization receives its survey results, NCQA assigns a date for the next required survey, to avoid a lapse in status.
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