About
We work with health plans and other organizations to assist them in obtaining NCQA accredition. Some of the steps we can help with include:
- Perform a Readiness Assessment to determine compliance with NCQA standards for Health Plan, Credentialing, Utilization Management, Case Management, Population Health, Provider Network, Health Equity.
- Review policies and procedures, materials and reports to identify areas of concern and make recommendations to meet compliance with standards
- Facilitate the comprehension of delegation oversight requirements, encompassing contract language, reporting, and template creation
- Identify areas of opportunity for health plan to streamline NCQA processes and project management
- Training on standard interpretation including auto-credit and scoring
- Review evidence to ensure meeting standard intent and bookmarking is appropriate at the Element and Factor level
- Identify any missing documentation and assist with creation or troubleshooting
- Assist with any evidence or questions from business owners and make sure all evidence is meeting regulatory requirements
- Upload documentation for NCQA standards to Interactive Review Tool (IRT)
- Serve as a SME for questions during file review and “onsite” virtual audit
- Participate with file review and interact with NCQA during virtual survey
We recognize that each client is unique and collaborate to create a tailored plan that suits their needs.