Utilization Management/Credentialing (UM/CR)

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.

     


UM/CR/PN is Now an Accreditation product

The most current versions of the UM/CR/PN product are now located under the Accreditation section in the NCQA Store.

Looking for the Application Packet for This Product?

The application process for Accreditation, Certification and Distinction is now managed through My.NCQA. Learn more about the new application and scheduling process.


  

3 Item(s)

Set Descending Direction
  1. 2016 UM/CR Survey Tool (web-based)

    Please click the link below for pricing information for this product.
    Click here for pricing by user level.
  2. 2016 UM/CR Standards and Guidelines (epub)

    Please click the link below for pricing information for this product.
    Click here for pricing by user level.
  3. 2016 UM/CR Standards and Guidelines (web-based)

    Please click the link below for pricing information for this product.
    Click here for pricing by user level.

3 Item(s)

Set Descending Direction