Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.
UM-CR 2016
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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8.23.2018 What is the price for Credentialing Accreditation?
8.23.2018 What organizations are eligible for Credentialing Accreditation?
Credentialing Accreditation is for organizations that provide full scope credentialing services. Eligible organizations:
- Must not be licensed as an HMO, POS, PPO or EPO.
- Must not be eligible for NCQA Accreditation as a health plan or an MBHO.
- Must perform credentialing functions directly or through a contract.
- Must perform credentialing activities for at least 50% of a practitioner network.
Note: A “practitioner network” is the practitioner network of clients and organizations.
UM-CR 2016
8.23.2018 What other organizations have earned Credentialing Accreditation?
More than 90 organizations have earned NCQA Credentialing Accreditation. See the NCQA Report Card for a directory of accredited organizations.
UM-CR 2016
8.23.2018 How long does it take to earn Credentialing Accreditation?
8.23.2018 How does Credentialing Accreditation help my organization?
NCQA Credentialing Accreditation is designed to ensure that organizations pursuing accreditation can maintain a high-quality network for members and contracted clients. The standards provide a framework for adopting industry best practices to accurately and efficiently credential and recredential health care professionals—ensuring that medical organizations employ qualified professionals and align with state requirements.
UM-CR 2016
8.23.2018 Where can I find the Standards and Guidelines?
Find the Standards and Guidelines document in the NCQA eStore.
UM-CR 2016
8.22.2018 Eligibility Where can we find more information about PCMH PRIME criteria and documentation requirements?
A list of the 13 PCMH PRIME criteria can be found on the HPC website here. The full PCMH PRIME requirements, including the criteria and all documentation requirements, is available for download at no cost from the NCQA Store.
8.20.2018 Where can I find information to help me get started?
- 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.
CM 2014
8.20.2018 What other organizations have earned Case Management Accreditation?
More than forty organizations have earned NCQA Credentialing Accreditation. See the NCQA Report Card for a directory of accredited organizations.
CM 2014
8.20.2018 What organizations are eligible?
Organizations in operation for at least 6 months and coordinate LTSS are eligible for accreditation; for example:
- Area Agencies on Aging.
- Aging and Disability Resource Centers.
- Centers for Independent Living.
- Other home and community-based organizations.
- Health plans that coordinate LTSS that do not provide medical/behavioral health benefits.
- Case management organizations.
- Other organizations that coordinate LTSS.
NCQA-Accredited MBHOs or health plans that offer comprehensive medical benefits and manage LTSS are not eligible for this accreditation but can earn LTSS Distinction.
CM-LTSS 2017
8.20.2018 What other organizations have earned LTSS Accreditation?
Over sixty organizations have earned NCQA Accreditation of Case Management for LTSS. See the NCQA Report Card for a directory of accredited organizations.
CM-LTSS 2017