FAQ Directory: Utilization Management, Credentialing and Provider Network

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12.15.2023 Updated CR Accreditation Eligibility and Reportable Events The 2024 CR Accreditation standards allow organizations that delegate more than 50% of primary source verifications to be eligible for Credentialing Accreditation, as long as all delegates have NCQA Credentialing Accreditation or NCQA Credentialing/CVO Certification. What happens if a delegate loses Accreditation/Certification status after the organization’s survey?

If an organization delegates more than 50% of primary source verifications and one or more of its delegates loses Accreditation/Certification status, NCQA considers this a Reportable Event. The organization must notify NCQA (through My.NCQA.org) within 30 calendar days.

UM_CR 2024