Organizations may use State Relay services to meet the TDD/TTY requirement, but must be able to provide alternative phone numbers or services if members are not able reach 711 due to technology restrictions.
FAQ Directory
Here are some of the most frequently asked questions about NCQA’s various programs. If you don’t see what you are looking for in one of the entries below, you can ask a question through My NCQA.
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11.15.2012 TDD/TYY requirements May organizations use State Relay services in lieu of offering TDD/TTY services?
11.15.2012 Applications for PHQ surveys How long after NCQA receives an application for survey does the survey begin?
NCQA suggests that organizations submit an application for survey at least 180 calendar days in advance of the date requested for their Initial Survey, but preferably applications will be submitted further in advance. Organizations should indicate their preferred survey date and NCQA will accommodate them if possible.
PHQ 2013
11.15.2012 Certification for information providers May an information provider earn certification for the pieces it provides (e.g., standards, methodology, underlying data), while its customer (i.e., health plan that publishes the information) pursues other pieces (e.g., member communication and complaints, physician communication)?
11.15.2012 Reapplying for certification When may an organization that fails to be certified reapply?
11.15.2012 Cost, resource use or utilization measures Are there standardized measures for cost, resource use or utilization? If there are none, what measures are plans using?
11.15.2012 Changing measure specifications With regard to patient experience measures, may we use items from CAHPS-CG but change the referent time period? For example, not rating the last 12 months, but rating the last visit and changing the response categories accordingly?
No. Changing the referent time period materially alters the measure and would therefore not qualify as a standardized measure for Element A. Patient experience measures endorsed, developed or accepted by the NQF, AMA PCPI, national accreditors or government agencies may be used, but the organization must follow the measure or instrument specifications as written.
PHQ 2013
11.15.2012 Differentiating Between Programs If an organization measures and takes action on both primary care and for specialty care practitioners where the methodology and actions are the same but the measures vary by specialty, is this one or more program?
In general, if an organization has a measure set in which a subset of the measures apply only to some specialties (broadly including primary care as a specialty), where the methodology and actions are the same (e.g. public reporting in the same manner regardless of specialty), NCQA treats that as one program. However, if there is more than one action (e.g. public reporting, P4P), we may count them as two programs (a public reporting program and P4P program).
PHQ 2013
11.15.2012 Following Standardized Measure Specifications Does a program have to use the most recent version of a measure to count it as a standardized measure in Element A?
11.15.2012 Physician requests For PQ 2 Element C, could a collaborative manage the process?
Yes. PHQ requirements do not prohibit a collaborative from managing a request for corrections or changes made by physicians, but the organization remains accountable and responsible for responding to complaints from consumers and to requests for changes from physicians or hospitals based on actions taken by the organization.
PHQ 2013
11.15.2012 Taking action on cost measures Is an organization prohibited from using cost efficiency if quality results are not available?
No. The organizations program must consider quality in conjunction with cost, resource use or utilization when taking action. However, if the organization is unable to identify standardized measures of quality for a particular specialty or if there is insufficient data on an individual physician, practice or group the organization can act on cost performance when quality performance is not known. This is allowed in order to maximize the availability of performance information but must be handled in a fully transparent manner so that it is very clear when a physician is designated as high value and when they are purely designated as low cost. Refer to the standards _ specifically the explanation in PQ1 D (on page 51) _ for further explanation.
PHQ 2013
11.15.2012 Collaborative data Must organizations include collaborative data for certification?
11.15.2012 Tools for readiness evaluations Is there a non-Web based tool available for our organization to use for self-assessment?
An organization can use the PDF version of the standards to assess readiness to undergo a survey, but in order to undergo a survey it must purchase and use the Web-based Interactive Survey System (ISS) Tool. To purchase the PDF version of the standards or the Survey Tool, visit the NCQA Web site (www.ncqa.org) or contact Customer Service at 888-275-7585.
PHQ 2013