FAQ Directory: Managed Behavioral Healthcare Organization Accreditation

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9.15.2018 Life-planning activities for Complex Case Management (CCM) Policies and Assessment Are organizations required to address life-planning activities at the first contact and start of the CCM initial assessment?

No. After consideration, NCQA removed the requirement for case managers to address life-planning activities at the start of the initial assessment (first contact). This FAQ replaces the previous FAQ issued on October 15, 2017 (which has been deleted) regarding first contact, and the workbook has been adjusted to accommodate the change.

MBHO 2019

9.15.2018 Terminated arrangements more than 90 calendar days before submission If an organization terminated an arrangement with an NCQA-Accredited/Certified/Recognized delegate more than 90 calendar days before it submitted the completed survey tool, is the organization eligible for automatic credit for the portion of the look-back period when activities were performed by the delegate?

Yes. For non-file review requirements, if the arrangement was terminated more than 90 calendar days before submission of the completed survey tool, the organization is eligible for automatic credit for the portion of the look-back period when the NCQA-Accredited/ Certified/Recognized delegate conducted activities. For file review requirements, automatic credit is applied if the delegate processed (or handled) the file, regardless of when the delegation arrangement was terminated.

MBHO 2019

8.24.2018 What is the price for Managed Behavioral Healthcare Accreditation?

Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.

MBHO 2019

8.24.2018 Where can I find the MBHO Standards and Guidelines?

8.24.2018 How do I get started with MBHO Accreditation?

If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.

MBHO 2019

8.24.2018 Where can I find information to help me get started with MBHO Accreditation?

8.24.2018 What are Managed Behavioral Healthcare Accreditation requirements?

The standards, provide a framework for implementing best practices to improve:

  • Quality Management and Improvement: Monitor, evaluate and improve the quality and safety of care.
  • Care Coordination: Coordinate medical care and behavioral healthcare for its members.
  • Utilization Management: Notifies members and practitioners about coverage decisions within required time frames.
  • Credentialing and Recredentialing: Verifies the credentials of the practitioners in its network.
  • Members’ Rights and Responsibilities: Written members’ rights and responsibilities policy exist.

To see the program requirement details, get the Standards & Guidelines document.

MBHO 2019

8.24.2018 What is Managed Behavioral Healthcare Organization Accreditation?

NCQA Managed Behavioral Healthcare Organization Accreditation is a comprehensive, evidence-based evaluation that reviews organizations to assure they use processes to deliver high-quality care and access. It provides a framework for organizations to align and improve operations in areas of quality improvement, care coordination, utilization management and credentialing and recredentialing and members’ rights.

MBHO 2019

8.24.2018 What other organizations have earned Managed Behavioral Healthcare Accreditation?

More than 30 organizations have earned NCQA Health Plan Accreditation. See the NCQA Report Card for a directory of accredited organizations.

MBHO 2019

8.24.2018 How long does it take to earn Managed Behavioral Healthcare Accreditation?

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.

MBHO 2019

8.24.2018 What organizations are eligible for Managed Behavioral Healthcare Accreditation?

Any organization that provides managed health care services may apply for the NCQA Managed Behavioral Healthcare Organization Accreditation if it meets the following criteria:

  • Has been in operation for at least six months, and
  • Enrolls or receives enrollment of an identifiable eligible population that is eligible to access the network, and
  • Provides comprehensive behavioral health care services through an organized delivery system across a continuum of care, and
  • Performs functions addressed in the standards (quality improvement, care coordination, utilization management, credentialing, member rights and responsibilities), either directly or through a service agreement, and
  • Has a process for monitoring, evaluating and improving the quality and safety of care.

MBHO 2019

8.24.2018 How does MBHO Accreditation help my organization?

  • Managed Behavioral Healthcare Organization Accreditation:
    • Provides a framework for internal quality improvement in:
    • Quality Management and Improvement.
    • Care Coordination.
    • Utilization Management.
    • Credentialing and Recredentialing.
    • Members’ Rights and Responsibilities.
  • Elevates your organization’s status in the marketplace.
  • Improves contracting opportunities.
  • Satisfies health plan requirements.

MBHO 2019