Share this page with a friend or colleague by Email. Links to various non-Aetna sites are provided for your convenience only. Obtain full pricing information by submitting a request through My NCQA. See the NCQA Report Card for a directory of accredited organizations. to Change Data, Security NCQA Accreditation standards are intended to help organizations achieve the highest level of performance possible, and create an environment of continuous improvement. NCQA Accreditation as of June 30, 2022. Treating providers are solely responsible for medical advice and treatment of members. The Dental Clinical Policy Bulletins (DCPBs) describe Aetna's current determinations of whether certain services or supplies are medically necessary, based upon a review of available clinical information. Go to the American Medical Association Web site. Report Cards - NCQA Aetna is committed to Accreditation by the National Committee for Quality Assurance (NCQA) as a means of demonstrating a commitment to continuous quality improvement and meeting customer expectations. If you do not intend to leave our site, close this message. Others have four tiers, three tiers or two tiers. In the past, health plans like Aetna have not systematically collected data on race and ethnicity. Health Standards, Data For language services, please call the number on your member ID card and request an operator. At least 9 months before desired survey start date: Begin the online application process. In addition to creating our own initiatives to fight disparities among our members, we encourage researchers at the nations top academic institutions and engage community-based organizations to address variations in health status and health care delivery among racial and ethnic populations. Ask a Question. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. License to sue CPT for any use not authorized herein must be obtained through the American Medical Association, CPT Intellectual Property Services, 515 N. State Street, Chicago, Illinois 60610. Weve improved every year from 2017 through 2021 in our Healthcare Effectiveness Data and Information Set HEDIS measures and. 12 months in advance: Become familiar with NCQA's required standards and processes. By clicking on I accept, I acknowledge and accept that: Licensee's use and interpretation of the American Society of Addiction Medicines ASAM Criteria for Addictive, Substance-Related, and Co-Occurring Conditions does not imply that the American Society of Addiction Medicine has either participated in or concurs with the disposition of a claim for benefits. We piloted new programs to help members manage addiction, depression, anxiety and eating disorders. Each main plan type has more than one subtype. Do you want to continue? What is NCQA Accreditation | Advanced Medical Reviews NCQA Health Insurance Plan Ratings Detail Together with Autism Comprehensive Educational Services (ACES), weve created the first Aetna Institute of Quality (IOQ) for autism.
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