The Standards and Guidelines document can be found in the NCQA eStore.
CVO
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.
The Standards and Guidelines document can be found in the NCQA eStore.
CVO
NCQA CVO Certification is designed to ensure organizations can maintain a high-quality network for members and contracted clients. The standards provide a framework for adopting industry best practices to promote accurate and efficient verification of practitioner credentials—ensuring that medical organizations employ qualified professionals and align with state requirements.
CVO
Find the Standards and Guidelines document in the NCQA eStore.
CM 2017
HP 2019
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.
CM 2017
NCQA standards are a roadmap for improvement—organizations use them to perform a gap analysis and align improvement activities with areas that are most important to states and employers, such as network adequacy and consumer protection. Standards help plans in:
HP 2020
An organization is eligible for the NCQA LTSS Distinction for a product/product line if:
Note: NCQA conducts LTSS Distinction Surveys at the legal-entity level. Organizations undergoing Interim Survey are not eligible for LTSS distinction.
Health plans that coordinate LTSS and do not provide medical or behavioral services are not eligible for this distinction but can earn Accreditation of Case Management for LTSS.
HP 2020
NCQA Health Plan Accreditation is the most widely recognized, evidence-based program in the industry dedicated to quality improvement and measurement. It provides a comprehensive framework for organizations to align and improve operations in areas that are most important to states, employers and consumers. It’s the only evaluation program that bases results on actual measurement of clinical performance (i.e., HEDIS measures) and consumer experience (i.e., CAHPS measures).
HP 2020
The first step to earning distinction 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 standards. NCQA conducts the survey and determines your distinction status within 30 days of the final review.
See a step-by-step process.
CM 2017
More than 40 organizations have earned Credentials Verification Organizations Certification. A directory of Certified organizations can be found at the NCQA Report Card.
WHP 2014