How many years of claims history are organizations required to obtain according to NCQA?

Organizations are required to obtain five years of claims history according to the National Committee for Quality Assurance (NCQA). This timeframe ensures that there is sufficient data to evaluate the performance and quality of care over a substantial period. A five-year claims history allows organizations to analyze trends in patient care, identify changes in practice patterns, and assess the effectiveness of various healthcare services.

Additionally, having a comprehensive claims history for this duration assists organizations in completing important annual reporting requirements, including performance measures and quality improvement initiatives. It provides a broader context for understanding healthcare utilization, patient outcomes, and service delivery effectiveness, which is essential for accreditation and quality assurance purposes.