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Evernorth Accreditations

 

Evernorth has earned accreditation and certification from The National Committee for Quality Assurance (NCQA) and URAC in acknowledgement of our longstanding history and strong commitment to quality in health care services. The nationally-recognized accreditations by NCQA and URAC affirms Evernorth’s mission statement to improve the health and well-being of the individuals we serve through an integrated approach to quality and affordability in health care. This mission and approach is a common value shared across several organizations and programs within Evernorth.

 

About the National Committee for Quality Assurance

 

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®1) is the most widely used performance measurement tool in health care. NCQA is committed to providing health care quality information for consumers, purchasers, health care professionals and researchers. For more information, please visit NCQA.org.

 

The following NCQA Accreditations and Certification underscores Evernorth's commitment to excellence, quality and affordable health care to the individuals we serve.

 

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NCQA Managed Behavioral Health Organization

 

Evernorth has earned full NCQA Managed Behavioral Healthcare Organization (MBHO) Accreditation for how well it manages its entire delivery system, including physicians, hospitals and other facilities, as well as administrative services. NCQA reviews include rigorous on-site and off-site evaluations conducted by a team of physicians and managed care experts. Earning Full Managed Behavioral Health Organization Accreditation from NCQA is a powerful validation of Evernorth's ongoing commitment to quality and demonstrates dedication to helping our customers. To view Evernorth’s Management Behavioral Health Organization Accreditation Report Card, please visit NCQA MBHO Report Card.

 

1 “HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).”

 

About URAC

 

URAC is an independent, non-profit organization that promotes health care quality through its accreditation, education and measurement programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry. For more information, please visit www.urac.org.

 

Evernorth has received the following URAC accreditation:

 

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URAC Health Utilization Management

 

Expires 9/1/2025

 

URAC accreditation provides a mark of distinction for organizations demonstrating their commitment to quality health care. Through Evernorth's Health Utilization Management Accreditation, URAC affirms the use of evidence-based guidelines and specific review requirements that meet the demands of a changing health care system. The utilization management programs are supported by reliable policies and procedures used during the review of health care services for medical necessity and appropriateness of care to help ensure easy access to care and correct administration of our customer’s benefits. To verify Evernorth’s Utilization Management - behavioral accreditation, please visit URAC.org.