Case Management
This program evaluates clinicians and practices that use teamwork and technology to deliver coordinated and patient-centered primary care.
Credentialing
This program evaluates clinicians and practices that use teamwork and technology to deliver coordinated and patient-centered primary care.
Population Health Program
This program evaluates clinicians and practices that use teamwork and technology to deliver coordinated and patient-centered primary care.
Utilization Management
This program evaluates clinicians and practices that use teamwork and technology to deliver coordinated and patient-centered primary care.
The ‘Accreditation in Utilization Management’ status reflects accreditation for the utilization management functions in place at the time of the accreditation survey.
NCQA recommends that Health Plan organizations check with UM organizations prior to contracting to confirm functions included in the accreditation such as denial and appeal recommendations or decision-making.
Why Accreditation Matters
Organizations that are accredited or certified by NCQA meet industry-leading standards for following best practices and providing high-quality care. Accreditation is also a signal that helps identify valuable contracting partners. Health plans that partner with an NCQA-Accredited/Certified delegate can create efficiencies within the delivery system and may reduce your oversight burden.
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