What does URAC Accreditation mean?

Posted by Melba Papamichael on May 14, 2019 4:18:21 PM

logo_urac.pngThe Utilization Review Accreditation Commission was incorporated in 1990 to offer health organizations an opportunity to have trained reviewers examine their operations and publicly ensure they are delivering care in a manner consistent with national standards. URAC accreditation is a way for a health care organization to demonstrate and highlight their commitment to Health Call Center quality and accountability.

blog-post-5.jpgCurrently there are only 39 companies with URAC Health Call Center accreditation.

The accreditation process 

URAC accreditation is a voluntary undertaking that requires reaccreditation every three years. The entire initial process can take up to 12 months or more and consists of a meticulous four-part review: 

  • Phase one of accreditation begins with building the application, during which an organization completes the required application forms and submits the base fee.
  • Phase two, called the desktop review, involves a team of URAC reviewers who examine submitted documents including those related to policies and procedures and evidence to show the Organization is following these procedures. Evidence may include reports, program descriptions, workplans, and training logs. Applicants often have to supply additional documentation at this stage in order to clarify any questions or pending issues.
  • Phase three is an on-site review that brings the same accreditation review team face-to-face with the organization’s management and staff. The reviewers may conduct audits, analyze personnel and credentialing files, and review quality management programs. The reviewers conduct a tour of the call center and interview personnel from all functional areas of accountability within the Organization including senior clinical oversight.
  • Phase four is the committee review, conducted by URAC’s Accreditation and Executive Committees, the group that will ultimately be responsible for delivering a decision for or against accreditation.

“It was a huge milestone for us when we first received our URAC accreditation, and we are dedicated to exceeding these standards and being a leading URAC accredited company,” states Dr. Lousine Alpern, VP of Clinical Services for AMR, “AMR provides quality Independent Medical Reviews and UR services and this is just one way that we accomplish this task.”

 

Melba Papamichael

Written by Melba Papamichael

Melba Papamichael is the Compliance Manager at Citra. She has several years of experience in managing complex projects, contracting, legal research, and policy and procedure development. She is responsible for leading Citra’s internal processes for promoting and ensuring compliance with laws, regulations, contracts, and policies.

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