Health Network

URAC’s Health Network Accreditation standards include key quality benchmarks for network management, provider credentialing, quality management and improvement, and consumer protection. URAC’s standards require health networks to establish self-monitoring practices, emphasizing quality assurance and improvement.

By achieving URAC’s Health Network Accreditation, organizations demonstrate that they have met URAC’s rigorous standards for quality and accountability.

The URAC-accredited health network:

  • Complies with applicable laws and regulations where it conducts business
  • Maintains a quality improvement program that includes measuring, monitoring, and evaluating services
  • Ensures appropriate patient protections are established, including policies for confidentiality, informed consent, dispute resolution and other issues
  • Emphasizes quality of care and quality of services in its provider selection criteria
  • Meets requirements for provider dispute resolution mechanisms
  • Implements a mechanism for participating provider suspension for consumer safety
  • Verifies the professional qualifications of participating providers and facilities
  • Meets rigorous requirements for a credentialing program
  • Monitors participating providers’ continuing compliance with criteria for network participation
  • Has a mechanism to conduct a consumer safety credentialing investigation when needed
  • Can respond on an urgent basis to situations that pose an immediate threat to the health and safety of consumers
  • Has a formal process to address consumer complaints in a timely manner
  • And more.

Who may apply?

Preferred provider organizations, payer- and provider-based models, behavior health networks, specialty medical networks (e.g., radiologists, audiologists, dentists, physical therapists, optometrists, long-term care providers, etc.), physician-hospital organizations, chiropractic networks, workers’ compensation networks, and medical transportation providers may apply.