FAQ Directory: Utilization Management, Credentialing and Provider Network

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10.15.2013 Core and Structural elements. What is the difference between core elements and structural elements?

Core elements are requirements that an organization must meet even if it has no clients.

Structural elements are requirements that the organization must meet even if it delegates 100% of the function. If an organization delegates the functions associated with a structural requirement, it must provide NCQA with its own programs or policies and procedures and evidence of approval of the delegates documentation.

UM_CR 2013