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FAQ Where can I find information to help me get started with LTSS Accreditation?
ncqa.org/programs/health-plans/long-term-services-and-supports/case-management-accreditation-for-ltss-only-health-plans/faqs/all/?faq=000012249Accreditation Process and Timeline: Key steps, timing and resources for a successful accreditation.Standards and Guidelines: The complete standards and guidelines, including the intent and scope…
FAQ What is the price for this Accreditation?
ncqa.org/programs/health-plans/long-term-services-and-supports/case-management-accreditation-for-ltss-only-health-plans/faqs/all/?faq=000012246Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.
FAQ What is the process for earning Accreditation?
ncqa.org/programs/health-plans/long-term-services-and-supports/case-management-accreditation-for-ltss-only-health-plans/faqs/all/?faq=000012245The first step to earning accreditation is a discussion with an NCQA program expert. Purchase and review the program resources, conduct a gap analysis and…
FAQ How does this Accreditation help my organization?
ncqa.org/programs/health-plans/long-term-services-and-supports/case-management-accreditation-for-ltss-only-health-plans/faqs/all/?faq=000012242Earning NCQA’s Accreditation of Case Management for LTSS can help organizations: Become more efficient. A focus on coordinated care, training and measurement can help organizations…
FAQ Where can I find information to help me get started with the LTSS Distinction?
ncqa.org/programs/health-plans/long-term-services-and-supports/ltss-distinction-for-health-plans/all/?faq=000012333Accreditation Process and Timeline: Key steps, timing and resources for a successful accreditation.Standards and Guidelines: The complete standards and guidelines, including the intent and scope…
FAQ When will the 2017 CM standards be effective and when will the 2014 CM standards year end?
ncqa.org/programs/health-plans/case-management-cm/faqs/all/?faq=000008324The 2017 CM standards are effective on or after January 30, 2017. For organizations that have already scheduled a survey through June 30, the 2014…
FAQ Is automatic credit available for Interim Surveys for organizations that delegate UM 13 (UM 12 in HP 2017), Triage and Referral for Behavioral Healthcare, Elements A and B to an NCQA-Accredited/Certif
ncqa.org/programs/health-plans/long-term-services-and-supports/ltss-distinction-for-health-plans/all/?faq=000008271Yes. Automatic credit is available for an Interim Survey if the organization delegates to an NCQA-Accredited/Certified health plan, MBHO or UM-CR. The delegate’s Accreditation/Certification Survey…
FAQ May health plans receive automatic credit for the new UM pharmacy elements if they delegate to organizations accredited or certified under standards years prior to 2016?
ncqa.org/programs/health-plans/utilization-management/faqs/um-cr-pn/?faq=000006274Organizations seeking accreditation or certification in UM under the 2016 standards may receive automatic credit for updating delegation agreements prior to survey tool submission, to…
FAQ What documentation must an NCQA-Certified CVO provide to an organization for an accreditation survey file review?
ncqa.org/programs/health-plans/credentials-verification-organization-cvo/faqs/all/?faq=000005323The organization and the CVO determine the documentation methods for reporting information. Acceptable methods include a checklist, the actual documents and access to electronic credentialing…
FAQ Are health plans required to report regulatory actions taken against the organization?
ncqa.org/programs/health-plans/case-management-cm/faqs/all/?faq=000004818Yes. The Agreement for Health Plan Accreditation Survey (the “Agreement”), specified in the “Organization’s obligations” section of the standards and guidelines, requires the organization to…
FAQ How and when must the organization notify NCQA of Reportable Events?
ncqa.org/programs/health-plans/case-management-cm/faqs/all/?faq=000004820The organization must notify NCQA, in writing, within thirty (30) calendar days of the issuance of the notice of sanctions, issuance of a fine or…
FAQ When are ER denial files included in the universe of files for file review during an Accreditation or Certification Survey?
ncqa.org/programs/health-plans/utilization-management/faqs/um-cr-pn/?faq=000002700Generally, ER denials are not included in the universe of files for initial UM decisions unless a denial is appealed. In that case, the ER…