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NCQA Certification

ConnectCare's NCQA Utilization Management Certification

NCQA Utilization Management Certification focuses on consumer protection and improvement in service to customers.  Standards recognize that organizations that apply for certification have open access networks, and can improve service quality and utilize customized structures to meet the purchaser needs.

Affirmative Statement About Incentives

  • Utilization Management (UM) decision-making is based only on appropriateness of care and service and existence of coverage.
  • ConnectCare does not specifically reward practitioners or other individuals for issuing denials of coverage.
  • There are no financial incentives for UM decision-makers; therefore there is nothing to encourage decisions that result in underutilization.

Certified by NCQA since 2007

NCQA Certified Utilization Management"Achieving Utilization Management Certification from NCQA demonstrates that ConnectCare has the systems, process and personnel in place to conduct utilization management in accordance with the strictest quality standards." -- Margaret E. O'Kane, President, NCQA

NCQA has reviewed and certified ConnectCare's Utilization Management functions only. For complete details on the scope of this review, visit www.ncqa.org.