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  1. 2025 CR/PN Standards and Guidelines (web-based)

    Product 11.30.-0001
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    2025 STANDARDS AND GUIDELINES FOR ACCREDITATION AND CERTIFICATION IN CREDENTIALING AND PROVIDER NETWORK
    Note: This publication is made accessible in NCQA's Interactive Review Tool (IRT) system. It ca...

  2. 2025 CR/PN Survey Tool (web-based)

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    2025 CREDENTIALING AND PROVIDER NETWORK SURVEY TOOL
    Note: This Survey Tool is accessed through NCQA's Interactive Review Tool (IRT) system.
    The Survey Tool includes all information needed to prepare a...

  3. 2025 CR/PN Standards and Guidelines (epub)

    Product 11.30.-0001
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    2025 STANDARDS AND GUIDELINES FOR ACCREDITATION AND CERTIFICATION IN CREDENTIALING AND PROVIDER NETWORK
    View Table of Contents for this Publication
    This publication outlines standards and features ...

  4. 2025 CR/PN File Review Access (web-based)

    Product 11.30.-0001
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    2025 FILE REVIEW SYSTEM ACCESS FOR CREDENTIALING AND PROVIDER NETWORK ACCREDITATION AND CERTIFICATION
    NCQA developed a new online system to efficiently manage the file review process required for sur...

  5. 2025 MBHO Survey Tool (web-based)

    Product 11.30.-0001
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    2025 MANAGED BEHAVIORAL HEALTHCARE ORGANIZATIONS SURVEY TOOL
    Note: This Survey Tool is accessed through NCQA's Interactive Review Tool (IRT) system.
    The Survey Tool includes all information needed to ...

  6. 2025 MBHO Standards and Guidelines (web-based)

    Product 11.30.-0001
    store.ncqa.org/index.php/catalog/product/view/id/5475

    2025 STANDARDS AND GUIDELINES FOR THE ACCREDITATION OF MANAGED BEHAVIORAL HEALTHCARE ORGANIZATIONS
    Note: This publication is made accessible in NCQA's Interactive Review Tool (IRT) system. It cannot b...

  7. 2025 MBHO Standards and Guidelines (epub)

    Product 11.30.-0001
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    2025 STANDARDS AND GUIDELINES FOR THE ACCREDITATION OF MANAGED BEHAVIORAL HEALTHCARE ORGANIZATIONS
    View Table of Contents for this Publication
    This publication outlines standards and features in-de...

  8. HEDIS MY 2024 Volume 5 (epub)

    Product 11.30.-0001
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    HEDIS MEASUREMENT YEAR 2024 VOLUME 5: HEDIS COMPLIANCE AUDIT: STANDARDS, POLICIES AND PROCEDURES
      View Table of Contents for this Publication
    Health plans must submit audited HEDIS data to ach...

  9. 2025 UM Standards and Guidelines (web-based)

    Product 11.30.-0001
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    2025 STANDARDS AND GUIDELINES FOR ACCREDITATION IN UTILIZATION MANAGEMENT
    Note: This publication is made accessible in NCQA's Interactive Review Tool (IRT) system. It cannot be downloaded. For a down...

  10. 2025 UM Survey Tool (web-based)

    Product 11.30.-0001
    store.ncqa.org/index.php/catalog/product/view/id/5467

    2025 UTILIZATION MANAGEMENT SURVEY TOOL
    Note: This Survey Tool is accessed through NCQA's Interactive Review Tool (IRT) system.
    The Survey Tool includes all information needed to prepare and submit ma...

  11. 2025 UM Standards and Guidelines (epub)

    Product 11.30.-0001
    store.ncqa.org/index.php/catalog/product/view/id/5466

    2025 STANDARDS AND GUIDELINES FOR ACCREDITATION IN UTILIZATION MANAGEMENT
    View Table of Contents for this Publication
    This publication outlines standards and features explanations and examples of h...

  12. 2025 UM File Review Access (web-based)

    Product 11.30.-0001
    store.ncqa.org/index.php/catalog/product/view/id/5465

    2025 FILE REVIEW SYSTEM ACCESS FOR UTILIZATION MANAGEMENT ACCREDITATION
    NCQA developed a new online system to efficiently manage the file review process required for surveys.
    The File Review Sy...