2020 UM/CR/Provider Network Standards and Guidelines (web-based)

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2020 STANDARDS AND GUIDELINES FOR ACCREDITATION IN UTILIZATION MANAGEMENT AND CREDENTIALING AND PROVIDER NETWORK

EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2020 - JUNE 30, 2021.
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This publication outlines standards and features explanations and examples of how to meet the standards, scoring guidelines, points and certification outcomes. Eligibility requirements, application information and policies and procedures are also included.

This publication is a web-based format. It is also available separately in a downloadable epublication format. Explore NCQA's publication formats on the Product & Publication Formats page.

Note: Purchase of the Standards and Guidelines is not necessary if purchasing the Survey Tool.