Utilization Management (UM)

Review NCQA's Utilization Management (UM) Accreditation. Utilization management helps ensure that patients have the proper care and the required services without overusing resources. NCQA Utilization Management Accreditation helps guarantee that organizations making these decisions are following objective, evidence-based best practices.

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  1. 2025 UM Survey Tool (web-based)
    2025 UM Survey Tool (web-based)
    EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2025 - JUNE 30, 2026
    As low as $640.00
  2. 2025 UM Standards and Guidelines (epub)
    2025 UM Standards and Guidelines (epub)
    EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2025 - JUNE 30, 2026
    As low as $350.00
  3. 2025 UM Standards and Guidelines (web-based)
    2025 UM Standards and Guidelines (web-based)
    EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2025 - JUNE 30, 2026
    As low as $350.00
  4. 2025 UM File Review Access (web-based)
    2025 UM File Review Access (web-based)
    EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2025 - JUNE 30, 2026
    As low as $275.00
  5. 2024 UM/CR/Provider Network Survey Tool (web-based)
    2024 UM/CR/Provider Network Survey Tool (web-based)
    EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2024 - JUNE 30, 2025
    As low as $640.00
  6. 2024 UM/CR/Provider Network Standards and Guidelines (epub)
    2024 UM/CR/Provider Network Standards and Guidelines (epub)
    EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2024 - JUNE 30, 2025
    As low as $350.00
  7. 2024 UM/CR/Provider Network Standards and Guidelines (web-based)
    2024 UM/CR/Provider Network Standards and Guidelines (web-based)
    EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2024 - JUNE 30, 2025
    As low as $330.00
  8. 2024 UM/CR/Provider Network File Review Access (web-based)
    2024 UM/CR/Provider Network File Review Access (web-based)
    EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2024 - JUNE 30, 2025
    As low as $275.00
  9. 2023 UM/CR/Provider Network Survey Tool (web-based)
    2023 UM/CR/Provider Network Survey Tool (web-based)
    EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2023 - JUNE 30, 2024
    As low as $640.00
  10. 2023 UM/CR/Provider Network Standards and Guidelines (epub)
    2023 UM/CR/Provider Network Standards and Guidelines (epub)
    EFFECTIVE FOR SURVEYS WITH A START DATE OF JULY 1, 2023 - JUNE 30, 2024
    As low as $350.00
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