UM/CR Certification

Utilization Management/Credentialing Certification

Physician Org_Utilization_RGB_lowres.jpgNCQA’s Organization Certification (OC) program is available to organizations that perform Credentialing (CR) and/or Utilization Management (UM) for health plans and other types of organizations eligible for NCQA accreditation or certification. Specialty plans such as Physician Org_Credandrecred_RGB_lowres.jpgchiropractic, dental, vision and indemnity plans are eligible to apply for the OC program. NCQA Certification provides these organizations the opportunity to demonstrate the quality of their UM and CR programs.

NCQA‘s certification review includes a rigorous on- and off-site evaluation conducted by a team of physicians and managed care experts. A review oversight committee of physicians analyzes the team's findings and assigns a certification status based on the organization’s performance against standards within applicable certification options.

Questions?

For more information, please e-mail customersupport@ncqa.org or call (888) 275-7585, M-F, 8:30 a.m. – 5:30 p.m. ET.



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UM/CR Report Card

View the Utilization Management/Credentialing Certification Report Card.

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