Managed Behavioral Healthcare Organization Accreditation FAQs

How does Accreditation help my organization?

• Managed Behavioral Healthcare Organization Accreditation:
  • Provides a framework for internal quality improvement in:
  • Quality Management and Improvement.
  • Care Coordination.
  • Utilization Management.
  • Credentialing and Recredentialing.
  • Members’ Rights and Responsibilities.
• Elevates your organization’s status in the marketplace.
• Improves contracting opportunities.
• Satisfies health plan requirements.

What are Managed Behavioral Healthcare Accreditation requirements?

The standards, provide a framework for implementing best practices to improve:

• Quality Management and Improvement: Monitors, evaluates and improves the quality and safety of care.
• Care Coordination: Coordinates medical care and behavioral healthcare for its members.
• Utilization Management: Notifies members and practitioners about coverage decisions within required time frames.
• Credentialing and Recredentialing: Verifies the credentials of the practitioners in its network.
• Members’ Rights and Responsibilities: Has a written members’ rights and responsibilities policy.

To see the program requirement details, get the Standards & Guidelines document.

Where can I find the Standards and Guidelines?

Find the Standards and Guidelines document in the Store.

What organizations are eligible for Managed Behavioral Healthcare Accreditation?

Any organization that provides managed health care services may apply for the NCQA Managed Behavioral Healthcare Organization Accreditation if it meets the following criteria:

• Has been in operation for at least six months, and
• Enrolls or receives enrollment of an identifiable eligible population that is eligible to access the network, and
• Provides comprehensive behavioral health care services through an organized delivery system across a continuum of care, and
• Performs functions addressed in the standards (quality improvement, care coordination, utilization management, credentialing, member rights and responsibilities), either directly or through a service agreement, and
• Has a process for monitoring, evaluating and improving the quality and safety of care.

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 MBHO standards. NCQA conducts the survey and determines your accreditation status within 30 days of the final review.

See a step-by-step process.

What is the price for Managed Behavioral Healthcare Accreditation?

Pricing is based on multiple factors. Obtain full pricing information by submitting a request through My NCQA.

How long does it take to earn Managed Behavioral Healthcare Accreditation?

The typical evaluation time frame is 12 months from application submission to decision, depending on an organization’s readiness. Some organizations may already be working within NCQA guidelines.

How do I get started?

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.

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.

What other organizations have earned Managed Behavioral Healthcare Accreditation?

More than 30 organizations have earned NCQA Health Plan Accreditation. See the NCQA Report Card for a directory of accredited organizations.