Health Plan Accreditation Process
This process helps organizations plan and execute activities to ensure they are ready for NCQA evaluation. The typical evaluation time frame is 12 months from application submission to decision, depending on the organization’s readiness. Some organizations may already be working within NCQA guidelines.
Before Applying
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Overview Discussion
Schedule a consultative call with a program expert at least 12 months before your desired survey start date.
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Purchase the Standards & Survey Tool
Develop a better understanding of the evaluation areas and requirements. Purchase 9–11 months from your desired survey start date.
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Perform a Gap Analysis
Approximately 9–11 months from your desired survey start date, perform a gap analysis by comparing the standards to your organization’s current processes.
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Submit the Pre-Application Form
To initiate the application process, contact your program expert to request a pre-application form. NCQA:
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Submit the Online Application
Once qualified, submit the online application and select the desired survey start date.
After Applying
Align With NCQA Requirements
Approximately 9 months before the survey start date, work to align your organization with the program standards. You should be fully aligned with the requirements 6 months before your survey start date.
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Submit the Survey Tool
Approximately 3 months before the survey start date, an Accreditation Services Coordinator will contact you to review the survey submission process and answer questions.
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Earn Health Plan Accreditation
Your accreditation status is determined within 30 days of the onsite file review or 90 days after survey submission.
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