Balancing access, quality, and cost

​As health insurers adopt tiered and narrow networks to manage costs, regulators now require minimum standards for access to care and services.​

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NCQA’s Provider Network Accreditation

We help organizations build and maintain high-quality networks that protect members and clients. Accreditation ensures that organizations:​

• Establish appropriate client agreements

• Verify provider credentials and safeguard credentialing information

• Conduct credentialing peer review

• Evaluate provider quality and monitor sanctions/complaints

• Apply objective, evidence-based standards

• Maintain adequate network capacity

• Ensure timely access to appointments

• Support continuity and coordination of care

• Provide accurate, up-to-date physician directories

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