ncqa what does a on demand course certifcate look like

What information will I need to show NCQA?

Format. CEC. Credits. NCQA Distinction in Multicultural Health Care (MHC) Cost $155NCQA Distinction in Multicultural Health Care (MHC) Category. Other Programs. Format. On Demand.

What is NCQA accreditation?

Requirements look at things like how the data are ingested, processes for managing the validating data, coding integrity, quality assurance and change management, governance and data security. Primary Source Verification (PSV): The PSV process verifies that the information in the final CCD file matches the actual original primary source data.

How long does it take to submit the cap to NCQA?

Credentialing is more than a “check-the-box” regulatory duty, it’s an essential safety component of the health care system. Health care organizations must establish the qualifications of their licensed medical professionals by assessing their background and legitimacy to provide care. NCQA Credentialing Accreditation focuses on consumer ...

How do I submit annual reporting requirements to NCQA?

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What is 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.

How long does it take to get NCQA certified?

How long does it take to earn Credentialing 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.

What is a Pcmh CCE?

The NCQA PCMH Content Expert Certification program certifies individuals who demonstrate comprehensive knowledge of the patient-centered medical home model of care and the NCQA PCMH Recognition Program, including a mastery of the NCQA concepts, criteria and the PCMH Recognition process.

How do I get NCQA accreditation?

Process: Becoming LicensedRequest 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.

How often is NCQA certification?

3 yearsAccredited-3 years: NCQA awards a status of Accredited – 3 years to organizations that demonstrate strong performance of the functions outlined in the standards for CM-LTSS accreditation.

What are the NCQA categories?

NCQA's CVO Certification program offers the following 11 credentialing certification options....Health Information Product (HIP): NCQA awards certification to organizations for:Pharmacy Benefits Information.Health Information Line.Support for Healthy Living.Physician and Hospital Directories.

How many Pcmh are there in the US?

The NCQA PCMH Recognition program is the most widely adopted PCMH evaluation program in the country. More than 13,000 practices (with more than 67,000 clinicians) are Recognized by NCQA.

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.Dec 1, 2021

What does NCQA review?

NCQA Utilization Management Accreditation assesses an organization's performance in the following areas: Improving operations through an internal QI process. Ensuring appropriate agreements and collaboration with clients. Maintaining member confidentiality.

What are the 5 domains of HEDIS?

HEDIS and Performance MeasurementEffectiveness of Care.Access/Availability of Care.Experience of Care.Utilization and Risk Adjusted Utilization.Health Plan Descriptive Information.Measures Reported Using Electronic Clinical Data Systems.

WHAT IS DATA AGGREGATOR VALIDATION?

NCQA’s Data Aggregator Validation program evaluates the ingestion, transformation and output of aggregated clinical data to ensure data integrity.

HOW DOES DATA AGGREGATOR VALIDATION HELP MY ORGANIZATION?

The Data Aggregator Validation program helps you and your contracting partners have confidence in the validity of aggregated clinical data used for things like quality reporting, value-based contracting and closing gaps in care.

WHAT ORGANIZATIONS ARE ELIGIBLE FOR PARTICIPATION IN THE DATA AGGREGATOR VALIDATION PROGRAM?

Validation is conferred to a data stream, so any organization the aggregates clinical data and outputs that data as CCD files is eligible to participate. For a data stream to be validated, all standards must be passed. Organizations that manage data streams and can meet all the standards on their own may bring through a data stream for validation.

WHAT IS THE PROCESS FOR GETTING A DATA STREAM VALIDATED?

The first step to validating a data stream is a discussion with an NCQA program expert. Purchase and review the program resources and conduct a gap analysis against the program requirements to ensure you will meet the program requirements. Once ready, submit your online application.

WHAT IS THE PRICE FOR DATA AGGREGATOR VALIDATION?

Pricing varies based on the number of clusters and amount of data being validated. To get a quote, contact an NCQA program expert.

HOW LONG DOES IT TAKE TO VALIDATE A DATA STREAM?

Validating a data stream takes between 12-18 weeks. However, NCQA has limited space in cohorts and space fills up quickly. Contact NCQA today to submit an application.

HOW DO I GET STARTED?

If you are interested in getting a data stream validated, contact NCQA. If you are a current Data Aggregator Validation customer and want to talk to someone about your status or about renewing, submit a question through My NCQA.

A QUALITY IMPROVEMENT FRAMEWORK

Credentialing is more than a “check-the-box” regulatory duty, it’s an essential safety component of the health care system. Health care organizations must establish the qualifications of their licensed medical professionals by assessing their background and legitimacy to provide care.

Why Credentialing?

Applying industry best practices improves credentialing processes. The standards provide a framework for implementing best practices:

What is annual report?

Annual Reporting includes attesting to certain policies and procedures and submission of key data. This process will sustain the practice’s recognition. Better yet, it’s designed to foster continuous improvement. That means the practice succeeds in strengthening its transformation, and as a result, patient care.

Can a practice change what they report?

Practices may change what they report from year-to-year, as long as it is within the set of options.

When Does Annual Reporting Begin?

Your PCMH Annual Reporting date is 30 days prior to your recognition anniversary date. All Annual Reporting data and documentation must be submitted no later than 30 days prior to your recognition expiration date. Practices that are a part of a multi-site organization share the same Annual Reporting date, unless otherwise requested.

What Will I be Asked to Do?

Annual Reporting requirements are flexible. You are probably performing the required tasks already as a PCMH and will only need to show NCQA what you are currently doing. Practices are asked to:

What Information Will I Need to Show NCQA?

Practices must submit data and documentation that cover the 6 PCMH concepts. Practices must meet the minimum number of requirements for each category. The 6 areas include:

How to Prepare for Annual Reporting

Download the Annual Reporting requirements. Look at what’s expected after recognition. You can also attend an Annual Reporting training.

How to Submit Your Annual Reporting Requirements

The entire recognition process is now managed through the Q-PASS system. You will use this system to upload documentation; track progress; manage practice sites, clinicians and recognition; and pay recognition fees.