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.

Filter Results
  • Save

    Save your favorite pages and receive notifications whenever they’re updated.

    You will be prompted to log in to your NCQA account.

  • Email

    Share this page with a friend or colleague by Email.

    We do not share your information with third parties.

  • Print

    Print this page.

expand all

9.15.2022 Differences Between Quality Compass Data and State of Healthcare What are the differences between the State of Healthcare (SOHC) report and the data included in Quality Compass?

The State of Healthcare Report includes data that is publicly available on the NCQA site. It contains national averages based on the prior measurement year and is updated once a year. The State of Healthcare Quality Report classifies health plans differently than NCQA’s Quality Compass. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. PPO corresponds to PPO and EPO within Quality Compass.
To get access to the most recent data as well as additional data points such as plan level performance and percentiles check out Quality Compass. at this link:

https://www.ncqa.org/programs/data-and-information-technology/data-purchase-and-licensing/quality-compass/

If you would like to discuss Quality Compass further, please reach out to our Information products team by submitting a case through your my.NCQA.org account.
 

HEDIS 2021

9.15.2022 Electronic signatures Are electronic signatures (e.g., DocuSign) acceptable?

Yes, if there is a unique electronic signature or identifier and if the organization can demonstrate that the signature/identifier can only be entered by the signatory. NCQA reviews organizations’ security and login policies and procedures to confirm that the signature/identifier can only be entered by the signatory.

HP 2022

9.15.2022 Quality Compass HEDIS Benchmark Percentiles: Payers and Patient Ages Do the Quality Compass products have the HEDIS benchmark percentiles across all payers and patient ages?

Only the measures whose results were eligible for public reporting are included in Quality Compass. Additionally, certain HEDIS measures are specific to certain product lines and do not have data across all product lines. Specific age and gender stratifications are only applicable to specific measures.
 

HEDIS 2021

9.15.2022 Follow-Up Care for Children Prescribed ADHD Medication (ADD) In step 1 of the Event/Diagnosis for Rate 1, what timeframe is used to identify dispensed ADHD medications?

In step 1 identify all children in the specified age range who were dispensed an ADHD medication during the 12-month Intake Period. This clarification will be in the MY 2023 Technical Update.

HEDIS 2023

9.15.2022 Quality Compass Data Comparison Across All Product Lines Is there a way to compare the data across product lines?

Currently each license is separated and there is no way to compare Commercial, Medicaid and Medicare in the same license. However, with the Data Exporter function, you will be able to pull reports in Microsoft Excel and that can make data comparison easier.
 

HEDIS 2021

9.15.2022 Social Need Screening and Intervention (SNS-E) For SNS-E, are organizations allowed to count screenings that were conducted using adapted or translated versions of screening instruments?

As an ECDS-reported measure, the SNS-E screening numerator counts only screenings that use instruments in the measure specification as identified by the associated LOINC code(s). Allowed screening instruments and LOINC codes for each social need domain are listed in “Definitions” in the measure specification.

NCQA recognizes that organizations might need to adapt or modify instruments to meet the needs of their membership. To clarify:

  • The SNS-E measure specification does not prohibit cultural adaptations or linguistic translations from being counted toward the measure’s screening numerators.
  • Only screenings documented using the LOINC codes specified in the SNS-E measure count toward the measure’s screening numerators.
  • The Regenstrief Institute, which maintains the LOINC database, has indicated that LOINC codes do not distinguish between adapted and translated instruments.
  • Tool developers have varying policies with regard to cultural adaptation and translations; some state that users may adapt screening instruments, others state that organizations must obtain permission first.

NCQA urges organizations to refer to the tool developer for information about adaptations or translations that are available or allowed.

HEDIS 2023

9.15.2022 Quality Compass Data Usage Update What if my data usage needs change after purchasing Quality Compass?

You can contact the Information Products team for assistance in expanding your permissions to meet your data usage needs. This includes any changes to the amount of data being shared (number of indicators) and how/with who the data is being shared with (internally for quality analysis purposes, external reporting on a brochure, email broadcast, website, blog) or commercial use of the data.
 

HEDIS 2021

9.15.2022 Use of expired board certification to verify education and training Can an expired board certification be used to verify education and training?

Yes. Because the board would have primary-source verified education and training before awarding certification, NCQA allows organizations to use expired board certifications to meet the requirements. Education and training information does not change even if board certification expires.

HP 2022

9.15.2022 Purchase Order Number Will NCQA accept a purchase order number?

Purchase order numbers may be included for payment and tracking purposes; however, NCQA does not accept additional terms and conditions outside the executed legal agreement. Any and all purchase order terms and conditions have no legal effect and the license is governed solely by the terms of the executed agreement between your entity and NCQA.
 

HEDIS 2021

9.15.2022 Durable medical equipment in the scope of credentialing Are durable medical equipment entities in the scope of credentialing?

Yes. Durable medical equipment entities are in the scope of CR 7, Element A, to the extent that organizations must have policies and procedures for initial and ongoing assessment of the entities with which it contracts. NCQA’s review of the organization’s assessment of organizational providers is limited to the organizations listed in CR 7, Elements B and C.

HP 2022

9.15.2022 Quality Compass Access When will I receive access to Quality Compass?

Access to the data is granted as soon as payment is received by check or credit card.

The default email address used for access will be the individual’s whose information was included under the “Ship To” section completed at checkout Login and password information will be emailed to the default user after NCQA sets up the account. The default user, also known as the Administrative User, will have access to manage the additional licensed users on the account.

 

HEDIS 2021

9.15.2022 MBHO: File Review Scope for NCQA-Accredited MBHOs seeking UM-CR-PN Accreditation How many files are reviewed in a UM-CR-PN Survey for Accredited MBHOs?

For UM Accreditation, 75 files are reviewed per product line.  For CR Accreditation, 75 initial credentialing files and 75 recredentialing files are reviewed. 

Note: For non-MBHO organizations, 30 files are reviewed per product line. 

MBHO 2022