NCQA Utilization Management Accreditation provides a framework for implementing industry best practices to ensure fair and timely utilization evaluations using objective, evidence-based criteria, collection and use of relevant clinical information to make utilization management decisions, as well as ensuring qualified health professionals assess requests and make utilization management decisions and alignment with state requirements.

NCQA Credentialing Accreditation focuses on consumer protection and customer service improvement. It provides a framework for organizations to implement industry best practices that help them accurately and efficiently credential and recredential health care professionals.