OVERVIEW

Health Plan Accreditation 2024: Credentialing (CR) is organized by National Committee for Quality Assurance (NCQA).

Expires: June 30, 2025

Description:
NCQA Health Plan Accreditation (HPA) is the only program in the industry that bases results on clinical performance and consumer experience (HEDIS® and CAHPS®).
This live, multi-day course leads learners through a deep dive into the HPA standards for Credentialing (CR). Through this course, presenters will provide you with insight to interpret the requirements, navigate the standards, and avoid misconceptions. In addition to answering live questions, the presenters address scenarios and examples based on performance improvement opportunities from prior NCQA surveys.

Key Topics:

System Controls for Credentialing.
Credentialing Committee and Oversight.
Verification of Credentials.
Ongoing Monitoring and Interventions.
Assessment of Organizational Providers Benefits.

Course Resources

Presentation slides.
Recording of live session.
Live Q&A.
Scenarios for applied learning.
NCQA surveyor's perspective of the standards.
IPCE Credits for physicians, nurses and pharmacists.

What You Will Learn
At the conclusion of this course, learners will be able to:

Interpret the intent of Health Plan Accreditation requirements for CR Standards.
Describe relationships and themes across CR Standards.
Recognize requirement implications and considerations for stakeholders.
Define performance improvement opportunities.

By achieving these learning objectives, participants may experience the following operational efficacies as three to nine month post-participation outcomes:

Increased productivity in prioritizing and planning interventions.
Improved practices in monitoring issues and risks.
Enhanced coordination in cross-functional efforts.
Refined tactics in monitoring performance.

ACCREDITATION & CREDITS

Continuing Education
In support of improving patient care, the National Committee for Quality Assurance is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), the American Nurses Credentialing Center (ANCC) to provide Interprofessional Continuing Education for the healthcare team.

This activity was planned by and for the healthcare team, and learners will receive 3.0 Interprofessional Continuing Education (IPCE) credit for learning and change.

This educational activity is approved for: 3.0 AMA PRA Category 1 CreditTM, ANA CNE and ACPE.

The assigned universal program number: JA0004597-0000-23-034-H04-P. Upon successful completion of this program (attending the full session and completing a program evaluation), participants will access CPE Monitor on the ACPE website to locate and track their CPE statement of credit.

This live course grants 2.0 Continuing Education Unit (CEU) points for PCMH Certified Content Experts.

NABP Credit Reporting
If you are a pharmacist completing a course offering CPE credits, please notify NCQA through ncqa.org within 14 calendar days that you have completed a CPE course. You must provide the title of the course, your NABP identification number and your DOB (month/date) within the notification to NCQA. We also recommend you update your education.ncqa.org profile with your NABP identification number.

3 AMA PRA Category 1 Credits™

2 CEU

3 IPCE

TARGET AUDIENCE

PhysicianPharmacistCliniciansHealthcare ProfessionalsNursesHealthcare ManagementVendor ManagementCase ManagersSafety & Risk managementPublic Health ProfessionalsConsultantsHealthcare ExecutivesPublic Health Decision Maker