Is NCQA accreditation required?
Twenty-seven states require that health plans serving their Medicaid population be accredited by NCQA – with seven others accepting our HPA as meeting broad accreditation requirements.
What is a NCQA certification?
NCQA Certification programs evaluate systems and processes that support data collection, surveys and quality improvement. NCQA-Certified vendors have gone through a rigorous process to validate accuracy and support your organization.
What are the NCQA accreditation levels?
Based on my status level today, what star rating should I expect?
| Current Status | Projected Stars |
|---|---|
| Excellent | 4.5-5.0 |
| Commendable | 3.5-4.0 |
| Accredited | 2.5-3.0 |
| Provisional | 1.0-2.0 |
How much does NCQA accreditation cost?
The organization pays $6,570 for its Initial Recognition Fee. The organization pays $1,922 each year during its annual reporting period….Pricing: Single Site.
| Number of Clinicians | Initial Recognition Fee | Annual Reporting Fee |
|---|---|---|
| 1-2 | $800 | $155 |
| 3-12 | $475 | $155 |
| 13+ | $55 | $15.50 |
What are NCQA guidelines?
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 evaluate plans on: Quality Management and Improvement.
How do I get NCQA accreditation?
Process: Becoming Licensed
- Request an application. Submit an inquiry through My NCQA.
- Review Handbook and Application. NCQA will send you the handbook and application.
- Submit the Application and Pay the Application Fee.
- NCQA Reviews the Application.
- Pay the Final Fee and Earn Your License.
- Maintain Your License.
What are the main goals of NCQA What does NCQA do?
Health Care Accreditation, Health Plan Accreditation Organization – NCQA – NCQA. The National Committee for Quality Assurance (NCQA) exists to improve the quality of health care. We work for better health care, better choices and better health.
Is NCQA accreditation voluntary?
NCQA Health Plan Accreditation is a voluntary review process. A national oversight committee of physicians analyzes the team’s findings and assigns an accreditation level based on the performance of each plan being evaluated to NCQA’s standards.
Why is NCQA accreditation important?
NCQA Health Plan Accreditation is a widely recognized, evidence-based program 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.
What is NCQA and hedis?
NCQA established Healthcare Effectiveness Data and Information Set (HEDIS) measures specifically for SNPs. HEDIS is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance.
Who needs NCQA certification?
Any organization that provides managed health care services can apply for the NCQA Health Plan Accreditation if it meets the following criteria: Operates under an insurance license (e.g., HMO, POS, PPO, EPO), and.