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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8.24.2018 Where can I find information to help me get started with Utilization Management Accreditation?

Accreditation 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 of review.
Interactive Survey Tool: Contains the complete standards and guidelines; you can also determine your organization’s survey readiness—the tool calculates your potential survey score.

UM-CR 2019

8.24.2018 Where can I find information to help me get started with Provider Network Accreditation?

Accreditation 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 of review.
Interactive Survey Tool: Contains the complete standards and guidelines; you can also determine your organization’s survey readiness—the tool calculates your potential survey score.

UM-CR-PN 2019

8.24.2018 Where can I find information to help me get started with MBHO Accreditation?

Accreditation 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 of review.
Interactive Survey Tool: Contains the complete standards and guidelines; you can also determine your organization’s survey readiness—the tool calculates your potential survey score.

MBHO 2019

8.24.2018 How do I get started with Utilization Management Accreditation?

If you are not currently accredited and want to learn more, contact NCQA. If you are currently accredited and want to talk to someone about your status or about renewing or adding accreditations, submit a question through My NCQA.

UM-CR 2019

8.24.2018 What is the process for earning Managed Behavioral Healthcare Accreditation?

The first step to earning accreditation is a discussion with an NCQA program expert. Purchase and review the program resources, conduct a gap analysis and submit your online application.
Align your organization’s processes with the CR standards. NCQA conducts the survey and determines your accreditation status within 30 days of the final review.
See a step-by-step process.

MBHO 2019

8.24.2018 How do I get started with MBHO Accreditation?

MBHO 2019

8.24.2018 How long will it take to earn CVO Certification?

The typical evaluation timeframe, from application submission to decision, is 12 months. This depends on the organization’s readiness, as some organizations may already be working within NCQA guidelines.

CVO

8.24.2018 Where can I find the Medicaid Module Standards and Guidelines? How can I obtain the Medicaid Module Standards and Guidelines?

Submit your request for the 2018 Medicaid Module at My NCQA.

HP 2020

8.24.2018 What organizations have earned CVO Certification?

More than 90 organizations have earned CVO Certification. A directory of Certified organizations can be found at the NCQA Report Card.

CVO

8.24.2018 What is the process for earning Provider Network Accreditation?

The first step to earning accreditation is a discussion with an NCQA program expert. Purchase and review the program resources, conduct a gap analysis and submit your online application.

Align your organization’s processes with the Provider Network standards. NCQA conducts the survey and determines your accreditation status within 30 days of the final review.

See a step-by-step process.

UM-CR-PN 2019

8.24.2018 How does Utilization Management Accreditation help my organization?

NCQA Utilization Management Accreditation is designed to ensure that organizations pursuing accreditation can deliver fair and timely determinations to get the proper care to patients while effectively managing resources. The standards provide a framework for adopting industry best practices to objectively and efficiently evaluate the appropriateness of requested health care services.

UM-CR 2016

8.24.2018 What is Long-term Services and Supports Distinction for Health Plans?

NCQA LTSS Distinction for Health Plans is a complementary program designed to support health plans coordinating LTSS. The program standards provide a framework for organizations to deliver efficient, effective person-centered care that meets people’s needs, helps keep people in their preferred setting and aligns with state requirements.

HP 2020