Delegation

HPA Delegation

Delegation standards enable health plans to give another organization the authority to perform a required process or function assessed against the NCQA standards.

Delegation Suite tools and templates can be purchased separately or as suite. HPA Delegation Suite is $10,000 if bundled for MHR Clients.

CM Accreditation Delegation Oversight Review Tool

Description: An delegation oversight audit tool used for Case Management.

Type: Tool

# of Pages:

Instructions - 3 pages
Cover Page - 1page
Scoring Summary - 3 pages

Cost: $1875 (MHR Client - $1500)

MHR Clients receive a 20% discount.

UM Accreditation Delegation Oversight Review Tool

Description: An delegation oversight audit tool used for Utilization Management.

Type: Tool

# of Pages:

Instructions - 3 pages
Cover Page - 1page
Scoring Summary - 3 pages

Cost: $1875 (MHR Client - $1500)

MHR Clients receive a 20% discount.

Delegation Toolkit by NCQA

Description: NCQA Toolkit that offers Delegation Guidance to Health Plans.

Type: External Resource

# of Pages: N/A

Cost: Free

Included in Delegation Suite: Yes

HP Delegation Suite Description

Description: List, with descriptions, of the MHR delegation tools and templates available for health plans.

Type: MHR Product Description

# of Pages: N/A

Cost: Free

Included in Delegation Suite: Yes

MHR Delegation Oversight Program Guide

Description: A comprehensive guide to establishing an NCQA-compliant delegation oversight program based on 2024 Standards. Includes how to identify vendors vs delegates, craft a delegation agreement, conduct a pre-delegation evaluation, conduct annual oversight and evaluate vendor reports.

Type: Guide

# of Pages: 24 total pages

Title and Table of Content - 3 pages
Content - 19 pages
NCQA FAQ's - 3 pages

Cost: $2500 (MHR Client - $2000)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

HP Delegation Oversight Audit Tool

Description: A tool for plans to audit their delegates for all delegation standards with scoring.

Type: Audit Tool

# of Pages:

Instructions - 3 pages
Cover page - 1 page
Scoring Summary - 17 pages
Audit Tool - 11 pages
QI Tab - 5 pages
PHM Tab - 7 pages
UM Tab - 19 pages
NET Tab - 7 pages
CR Tab - 7 pages
ME Tab - 9 pages
MED Tab - 17 pages

Cost: $3750 (MHR Client - $3000)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

Delegate Report Tracking Tool

Description: A tool for clients to use to track Delegate Report submission. Provides instructions for Use of Delegate Report Tracking Grid.

Type: Tracking Tool

# of Pages:

Instructions Tab
Delegate Tabs

Cost: $313 (MHR Client - $250)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

Delegate Audit Request Letter Template

Description: A template letter used by the health plan to inform their delegate of an annual review and request the delegate's documents needed to comply with NCQA standards.

Type: Template

# of Pages: 3 pages

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

Delegation Agreement Checklist

Description: An audit tool listing requirements for Delegation Agreements with columns to enter if information is present, a description for missing information, and a plan to correct.

Type: Tracking Tool

# of Pages: 3 pages, Tables

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

Print Mail Distribution Vendor Delegate Tracking

Description: An 11-column Excel file to track entities responsible for distributing notifications to members and determine if the relationship falls under vendor or delegation. Applicable to PHM, NET, UM, and ME standards.

Type: Tracking Tool

# of Pages: 1 tab, Headers only

Cost: $313 (MHR Client - $250)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

Delegate Notification - Data for Clinical Performance and Member Experience Data

Description: A tool to log notifications sent to delegates in place prior to 1/1/19 informing them of the process for requesting member experience and clinical performance data.

Type: Template

# of Pages: NA

Cost: FREE for MHR clients only.

Included in Delegation Suite: Yes

2024 CR - Delegation Agreement Tables

Description: Tool to list the delegate and health plan responsibilities for the delegation agreement for the CR standards. Includes a table on reporting requirements.

Type: Template

# of Pages: 8 pages, tables

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

ME - Delegation Agreement Table

Description: Tool to list the delegate and health plan responsibilities for the delegation agreement for the ME standards. Includes a table on reporting requirements.

Type: Template

# of Pages: 12 pages, tables

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

NET - Delegation Agreement Tables

Description: Tool to list the delegate and health plan responsibilities for the delegation agreement for the NET standards. Includes a table on reporting requirements.

Type: Template

# of Pages: 9 pages, tables

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

PHM - Delegation Agreement Tables

Description: Tool to list the delegate and health plan responsibilities for the delegation agreement for the PHM standards. Includes a table on reporting requirements.

Type: Template

# of Pages: 10 pages, tables

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

QI - Delegation Agreement Tables

Description: Tool to list the delegate and health plan responsibilities for the delegation agreement for the QI standards. Includes a table on reporting requirements.

Type: Template

# of Pages: 7 pages, tables

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

UM - Delegation Agreement Tables

Description: Tool to list the delegate and health plan responsibilities for the delegation agreement for the UM standards. Includes a table on reporting requirements.

Type: Template

# of Pages: 21 pages, tables

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

System Controls_CR Delegation Agreement Template

Description: Template agreement for delegating credentialing system controls. It explains the sampling methodology to audit files to detect modifications of information that do not meet the delegate's policies.

Type: Template

# of Pages: 2 pages, tables

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

System Controls_UM Delegation Agreement Template

Description: Template agreement for delegating utilization management system controls. It explains the sampling methodology to audit files to detect modifications of information that do not meet the delegate's policies.

Type: Template

# of Pages: 2 pages, tables

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

CR 1C_D Delegate CR Systems Controls Oversight Summary Report

Description: Template for organizations to complete during annual oversight audits to document the delegates' performance related to CR System Controls Audits. The template includes a table to capture system controls audit results.

Type: Analysis Template

# of Pages: 5 pages

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

UM 12A_B Delegate Denial Systems Control Oversight Summary Report

Description: Template for organizations to complete during annual oversight audits to document the delegates' performance related to UM Denial System Control Audits. The template includes a table to capture system control audit results.

Type: Analysis Template

# of Pages: 5 pages

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

UM 12C_D Delegate Appeal Systems Control Oversight Summary Report

Description: Template for organizations to complete during annual oversight audits to document the delegates' performance related to UM Appeal System Control Audits. The template includes a table to capture system control audit results.

Type: Analysis Template

# of Pages: 5 pages

Cost: $625 (MHR Client - $500)

Included in Delegation Suite: Yes

MHR Clients receive a 20% discount.

UM Mail Service Delegation

Description: A compilation of references from 2023 of NCQA's FAQs and PCS inquiries related to delegating mail services. Applies to HP and MBHO.

Type: MHR Resource

# of Pages: 15 pages

Cost: Free for MHR Clients Only

Included in Delegation Suite: Yes

Purchase

MHR Tools and Templates

HPA Delegation

CM Accreditation Delegation Oversight Review Tool

UM Accreditation Delegation Oversight Review Tool

Delegation Toolkit by NCQA

HP Delegation Suite Description

MHR Delegation Oversight Program Guide

HP Delegation Oversight Audit Tool

Delegate Report Tracking Tool

Delegate Audit Request Letter Template

Delegation Agreement Checklist

Print Mail Distribution Vendor Delegate Tracking

Delegate Notification - Data for Clinical Performance and Member Experience Data

2024 CR - Delegation Agreement Tables

ME - Delegation Agreement Table

NET - Delegation Agreement Tables

PHM - Delegation Agreement Tables

QI - Delegation Agreement Tables

UM - Delegation Agreement Tables

System Controls_CR Delegation Agreement Template

System Controls_UM Delegation Agreement Template

CR 1C_D Delegate CR Systems Controls Oversight Summary Report

UM 12A_B Delegate Denial Systems Control Oversight Summary Report

UM 12C_D Delegate Appeal Systems Control Oversight Summary Report

UM Mail Service Delegation

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