3 easy steps to begin your URAC accreditation

Obtain

the standards at the URAC store

Request

a quote / consultation

Three Stages of Accreditation - Sign the agreement

Sign

the application agreement for accreditation

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URAC is widely recognized by nearly every state and the federal government for health utilization management.

The updates to URAC’s Health Utilization Management Accreditation program reduces accreditation application document uploads by more than 50% and can save your organization around three staff working days!

Overview

URAC is widely recognized by nearly every state and the federal government for our health utilization management accreditation program.

With our origins in utilization review and utilization management, URAC set the bar for Health Utilization Management (HUM) in 1990 with the development of the first utilization management accreditation standards. Now, URAC-accredited organizations serve patients in every state across the country.

URAC’s accreditation program assures the clinical and operational soundness of your health utilization management process by evaluating it against a stringent set of nationally recognized, evidence-based standards and measures. With URAC’s HUM standards, organizations maintain the highest confidentiality in UM processes to protect all parties–patients, providers and payers.

Our program continues to evolve as the health care landscape changes. Traditionally, UM focused more on cost containment methods; it is now seen as a valuable tool to ensure accessibility, quality and timeliness of care. With input from industry experts and valued clients, we have conducted numerous revisions to the original standards. This way, we keep pace with the changing health care industry while defining best practices grounded by real experience.

URAC Health Utilization Management Accreditation is the industry standard; it indicates your organization delivers the highest quality of care to your patients.

Benefits of HUM Accreditation

Earning the URAC Health Utilization Management Accreditation Seal is a mark of distinction for organizations that demonstrate their commitment to quality and HUM accountability. It also boosts your credibility among key stakeholders: patients, provider practices, facilities and purchasers. Additionally, URAC accreditation:

  • Ensures the provision of consistent, unbiased medical necessity determinations by appropriately credentialed staff
  • Enhances your ability to improve the quality and effectiveness of patient care while eliminating unnecessary treatment and expense
  • Helps you protect patient safety and mitigate risks such as contraindicated treatments, adverse drug interactions or inappropriate treatment
  • Validates compliance and adherence to applicable state and federal regulations
  • Implements risk management oversight and review protocols that prevent, protect and manage client liabilities
  • Develops a roadmap for ongoing UM process and quality improvements rooted in evidence-based treatment guidelines that enhance care delivery, lower overall health care costs and optimize operational efficiencies

Learn How to Get Started With Health Utilization Management Accreditation

Take our Health Utilization Management Accreditation Lesson

Is Your Organization Ready for HUM Accreditation?

As the leading accreditor in HUM at the state and federal level, URAC’s standards are applicable to stand-alone utilization management organizations and utilization management functions within health benefits programs. We award HUM accreditation for a full three years.

Are you ready for URAC HUM Accreditation? See the ten general requirements for accreditation and how your organization can prepare to meet each one.

Getting started with Health Utilization Management Accreditation (click to download)

What to Expect

Within six months or less, we will collaborate with your team to create a flexible framework for continuous improvement in utilization management. While our experts define the standards of excellence for HUM programming, they do not prescribe how organizations must meet those standards.

URAC’s thorough approach stimulates innovation across the continuum of care through email, conference calls and educational webinars.

View our Health Utilization Management Standards-at-a-Glance for more information.