No. Delegate files may be audited using one of the following methods as described in the factor explanation and noted below:
- 5 percent or 50 of its files, whichever is less, to ensure that information is verified appropriately.
- The NCQA “8/30 methodology” available at https://www.ncqa.org/programs/health-plans/policy-accreditation-and-certification/
Either methodology is allowed, for consistency with other Delegation Oversight requirements for annual file audits.
UM_CR 2022