Utilization Management/Credentialing/Provider Network (UM/CR/PN)

  • 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.
  • Review NCQA's Credentialing (CR) Accreditation. Credentialing 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.
  • Review NCQA's Provider Network (PN) Accreditation. Provider Network Accreditation creates a framework for organizations to provide efficient, accurate and consistent network management and credentialing services.
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