Feb 6, 2010 · NCQA is the leader in health care accreditation. From physicians to health insurance companies, NCQA is the top health care accreditation organization.

Jan 15, 2025 · See Accreditation status and health plan rating for Kaiser Foundation Health Plan of Colorado on NCQA Report Cards.

Nov 18, 2024 · NCQA may consider use of AI in determining Accreditation/Certification status, even though current NCQA standards do not specifically address AI. For example, with regard to utilization management, NCQA standards require appropriately licensed professionals (not AI) to make medical necessity denial decisions. Other activities that require human

Nov 18, 2024 · NCQA Accreditation requirements. Failure to timely comply with requested corrective action may result in a lower score or reduction or loss of Accreditation status. A CAP is considered complete when NCQA notifies the organization that all identified deficiencies are resolved and corrective actions have been implemented.

Nov 18, 2024 · performing NCQA-reviewed functions, and must describe how it meets NCQA’s definition of an accreditable, certifiable or eligible entity. A parent, holding or shell

Nov 18, 2024 · NCQA may consider use of AI in determining Accreditation/Certification status, even though current NCQA standards do not specifically address AI. For example, with regard to utilization management, NCQA standards require appropriately licensed professionals (not AI) to make medical necessity denial decisions. Other

Nov 18, 2024 · This document includes the corrections, clarifications and policy changes to the 2024 Health Plan Accreditation standards and guidelines. NCQA has identified the appropriate page number in the publication the standard/element head and subhead for each update.

Nov 18, 2024 · Accreditation or Certification status as specified below. CL 11/23/20 NCQA Corrections, Clarifications and Policy Changes to the 2020 WHP Standards and Guidelines

NCQA Health Plan Accreditation requirements guide organizations to deliver high quality care that aligns with areas most important to states, employers and consumers. Requirements cover these key areas: Quality improvement. Population health management. Network management. Utilization management. Credentialing and recredentialing.

NCQA Health Plan Accreditation builds upon more than 30 years of experience to provide a current, rigorous and comprehensive framework for essential quality improvement and measurement. It is the only program in the industry that bases results on clinical performance and consumer experience (HEDIS ® and CAHPS ® ).