Knowledge Center

NCQA

David Gorelick's picture

As the Fall of '09 comes around, I am in the process of applying for NCQA certification - it has been quite the journey.  If you go through the entire application it breaks down the office workflow from soup to nuts.  Policies, procedures, reports, etc need to be created and implemented, with reporting to show that the processes  are in place.  This message board might be an appropriate place for those that are considering the application.

Structuring the office to achieve a quality rating can help improve many facets of the medical office and ultimately improve the quality of care.  To achieve higher quality ratings you will need to implement a very capable EMR system with different interfaces and the capacity to report on a multitude of administrative and clinical parameters.  Pay for performance program participation relies on the use of electronic record systems - the added reimbursement helps offset the cost as you attain a higher level of efficiency in the workplace.  As pay for performance becomes more mainstream, having NCQA level 2 or 3 certification may provide higher reimbursement for your work.  It may also facilitate recruitment of more primary care physicians into the community. 

The goals are within reach with the current systems out there, you need to keep the coffee streaming and dedicate yourself to the projects to be successful.

 

Jennie Chiller's picture

Congratulations!  What an accomplishment!  That's a tremendous amount of work and you and your office certainly should be proud!

David Gorelick's picture

I am proud to announce that my practice's two site - in Newport and Portsmouth, R.I. - have achieved level 3 PCMH recognition from NCQA.

David Gorelick's picture

It has been 4 1/2 months since we applied for NCQA PCMH recognition.  We inquire periodically and are repeatedly informed that they are a little behind on their 60 day turnaround time but we should have our results soon. We created a very organized application with color-coded, numbered, arrows bringing the reviewer directly to where they needed to be charts, diagrams, etc. Despite that, we sit and wait. I thought it would be good to let others know in-case they are submitting applications hoping for a quick result. I suppose smaller applications might have the advertised 60 day turnaround, maybe it is just the breadth of our application that requires more time. I read more and more about offices applying for NCQA recognition, I just wonder how well the NCQA organization is staffed to handle the onslaught.