I know you’ve heard me comment on how it is becoming progressively more difficult to conduct NCQA surveys due to poor documentation preparation.
Starting with surveys conducted in July 2012, NCQA will be enforcing its Document Preparation Guidelines.
The guidelines specify that organizations are expected to provide the necessary documents in an organized and readable format. Documentation should be limited to what is minimally necessary to demonstrate compliance. The organization is also expected to use highlighting, comments, hyperlinks and other software tools to direct the surveyors to the evidence of compliance.
Did you catch that?
You need to know what is required to demonstrate compliance and to present it in an easy-to-understand manner. If you include numerous documents and/or the evidence of compliance is not clear, the surveyors will ask for clarification rather than struggle to read everything that is presented.
NCQA summed up the situation nicely: “The onus is on the organization to demonstrate compliance, not on the team to find compliance.” [Emphasis in original.]
Remember, you have two opportunities provide evidence of compliance after the initial ISS submission. The first is when you respond to NCQA’s outstanding issues form. The second is following the conference call with the survey team. If you do not follow the documentation guidelines and the surveyors ask for clarification, you will have wasted the one of your two opportunities to provide additional documentation.
