Ncqa Delegation Agreement

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Managed Care certification defines delegation as a formal process in which an organization entrusts a different entity with the authority and responsibility to perform certain functions on its behalf through a contractual agreement. For health plans that wish to delegate elements of their registration process to another company, the CAAQ and URAC require the presence of several elements, including a pre-transfer assessment, a delegation agreement and surveillance assessment activities. Regardless of the delegated qualification activities, accreditation bodies always consider the health plan to be responsible for the full certification of its suppliers. The delegation agreement must be mutually agreed between the health plan and the delegated body through a dated and binding document, which is a stand-alone contract or an addendum to an existing agreement. This agreement must contain various elements to support the agreement, including the following source: This content has been extracted from care management: Compliance Strategies for Health Plans, CVOs, and Delegated Entities by Amy M. Niehaus, CPMSM, CPCS, MBA…