CREDENTIALING

Our credentialing program ensures all participating physicians and practitioners are measured and evaluated by definable and consistent criteria in accordance with the requirements of the National Committee for Quality Assurance (NCQA). 
 
NCQA, the gold standard in the evaluation of health care quality, is an independent, non-profit organization dedicated to measuring the quality of America's healthcare. Employers, patients, regulators and health plans rely on NCQA as a trusted authority.
 

The Quality Alliance received an NCQA score of 100%!

The Quality Alliance achieved its first Physician Organization Certification from the NCQA for credentialing and recredentialing activities in 2009. We continue to maintain this certification with outstanding scores. 
 

NCQA certification alleviates the administrative burden of credentialing and recredentialing.

Our NCQA certification is a valuable asset, as we continue to work on behalf of our members to contract with a wide variety of health plans that require this certification. NCQA certification demonstrates that the Quality Alliance continually works to ensure a quality panel of practitioners.

The services provided through our delegated credentialing arrangements include, but are not limited to:
  • Maintaining compliance with NCQA, health plan, state and federal requirements
  • Maintaining compliance with Ohio House Bill 125
  • Maintaining documents required by health plans
  • Completing on-site and desk-top audits with health plans
  • Ensuring the integrity of applicants’ credentialing and recredentialing information prior to submitting their application to our Membership and Credentialing Committee
  • Timely, efficient and confidential submission of demographic data and credentialing and recredentialing information to health plans via a monthly update file to ensure optimal service delivery and financial performance