Accreditation Process

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URAC’s approach to the accreditation process facilitates learning in the client organization. Rather than simply checking off a list of requirements, the organization going through our accreditation process is creating a framework for continuous improvement. While URAC sets the standards, we do not dictate how they are achieved. This approach supports and stimulates local innovation. And is the real value in achieving the URAC accreditation seal.

Navigating the Accreditation Process

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Two-Part Application Process

As a URAC client, you’ll be assigned an account manager and access to the secure web portal, AccreditNet®. You’ll begin the two-part application process.

  • Part One is required to approve your organization as an applicant
  • Part Two includes uploading required information to AccreditNet®
  • Completion of the application process is usually six to nine months.
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Desktop Review

In the Desktop Review (DTR) period, your documentation is checked to ensure it demonstrates compliance with URAC standards.

  • Deficiencies in the application are addressed through a Request for Information (RFI)
  • You may communicate with URAC reviewers via email, telephone, or web conferencing
  • The initial DTR usually takes 30 to 45 days
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Validation Review

The validation review is conducted at your location(s) or through web conferencing, depending on the accreditation program.

  • Your leadership and staff members are interviewed
  • Reviewers validate implementation of systems, work processes, and policies and procedures described in the DTR
  • You’ll get a debriefing of the findings at the end
  • URAC generates a score representing your organization’s compliance level
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Committee Review

This is a formal assessment by URAC’s volunteer Accreditation Committee, which comprises recognized experts in healthcare fields relevant to the accreditation program you are pursuing.

  • The Accreditation Committee considers the review findings, along with the validation review score, to determine your application status
  • Full accreditation and other designations are awarded or discussed
  • You’ll be notified of the results normally within one week of the decision
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Monitoring

Monitoring is key to ensuring sustainability of the programs covered by URAC accreditation.

  • Many of URAC’s programs require organizations to collect and report quality measures on an annual basis
  • URAC may provide 14 day’s notice to conduct a mid-cycle Onsite Review to confirm ongoing compliance

Accreditation FAQs

Why is accreditation important?

In a complex industry where there’s a lot at stake, such as healthcare, it’s critical to everyone involved that national standards for quality, accountability, consumer protection, and more, are being met. The best way to do that is through accreditation by an independent, third party.

What makes URAC accreditation programs unique?

URAC’s independent approach to accreditation sets us apart.  We rely on our multidisciplinary expert advisory groups from across healthcare to guide standard development.  The result is programs with rigorous, evidence-based standards that sets us apart as the “gold standard” accreditor for many of our programs. 

How are URAC standards developed?

URAC relies on multidisciplinary expert advisory groups from across healthcare to guide standard development and to inform the revision of existing programs.  All new programs and revisions are posted for public comment before release.

What does URAC stand for?

URAC was originally incorporated under the name Utilization Review Accreditation Commission.  That name was shortened to the acronym URAC in 1996 when we began accrediting other types of organizations such as health plans, pharmacies, and provider organizations.

Why do organizations pursue URAC accreditation?

Our clients pursue accreditation for a variety of reasons.  Accreditation may be a regulatory or network requirement.  Some leaders and teams use accreditation to improve performance and demonstrate value.  They know that accreditation provides a standards framework to build a quality health service organization and allows for performance analysis to identify areas for improvement.  They use the measurement, reporting and monitoring requirements of accreditation to promote continuous quality improvement. While the accreditation process is rigorous and requires a significant commitment from the organization, the comment we hear most after accreditation is achieved is, “Thank you for making us better.”

How do I get started with accreditation?

The first step is to determine your eligibility for the specific program you wish to be accredited. The pricing quote is the next step prior to signing an Accreditation Application Agreement or AAA.  You can connect with a URAC Business Development Executive who can get you started. Send an email to businessdevelopment@urac.org or call 202-326-3943.

What is an Accreditation Application Agreement or AAA?

An Accreditation Application Agreement is the legal contract that sets forth the terms and conditions to apply for a URAC accreditation program.

Does URAC accredit international (non-US) organizations?

URAC accredits companies incorporated in the United States. It does not accredit companies that are not incorporated in the United States. In the case where a company incorporated in the United States has international (non-US) operations, those non-US operations will be reviewed as a part of the accreditation. It is expected that companies incorporated in the US will facilitate virtual validation reviews for non-US operations. There are no exceptions.

How much does URAC accreditation cost?

The fee to apply for accreditation is unique to each of URAC’s programs. The application fee includes the desktop review, validation review, monitoring reviews, access to URAC’s accreditation guide, standard interpretations, and educational webinars to help organizations learn more about the process of accreditation. For a detailed analysis of your organization’s specific needs, please contact URAC at businessdevelopment@urac.org.

How long does the accreditation process take?

The entire accreditation process usually takes about 10 -12 months.  Once an application is submitted, it usually takes about six months to complete an accreditation review and receive a determination.

Should I use a consultant to help with accreditation?

Some organizations find that consultants are helpful while pursuing accreditation, but this varies based on the readiness and resources of each organization.  It is key to recognize that the use of a consultant will not necessarily lead to accreditation.  Please note that consultants are not allowed to be the point-of-contact for your organization or attend validation reviews.  URAC finds it most beneficial to the accreditation process to interact directly with the owner of the operations, quality culture and outcomes being reviewed.

Does URAC endorse specific consultants?

URAC does not have an independent process by which to evaluate the effectiveness of accreditation consulting services.  As such, we do not endorse or recommend the services of specific consultants.

How do I submit my application?

Applicants submit their application and supporting documentation through URAC’s secure web-based accreditation portal called AccreditNet.

What is a Desktop Review?

URAC uses a Desktop Review process to review an organization’s documentation to make sure you are ready for a Validation Review.  Applicants submit documentation for each standard in URAC’s secure, web-based accreditation portal called AccreditNet and URAC Reviewers evaluate the submission to confirm compliance with URAC standards.  Recommendations are provided through the scoring process and Applicants have an opportunity to submit additional/amended documentation through a Request-for-Information process.  

What is a Validation Review?

URAC conducts a Validation Review to confirm compliance with the standards as described in the submitted Desktop Review documentation.  Validation Reviews are often performed onsite, but may be conducted virtually and consist of interviews of leadership and staff, observation/tour, file reviews, and documentation review.

Who are URAC’s Accreditation Reviewers?

URAC is proud to employ an all-clinician staff of nurses and pharmacists with a passion for quality to conduct the accreditation review process.  Many of our reviewers have experienced URAC accreditation as a client in a past life. 

How are accreditation decisions made?

URAC’s Accreditation Committee, comprised of multidisciplinary healthcare experts from accredited organizations, review blinded applications and make accreditation decisions. 

How long is the URAC accreditation cycle?

Most accreditations are awarded for a period of 3 years.  However, we do have 2 programs with a 2-year cycle (Health Content Provider and Health Website).

What resources are available to applicants?

URAC offers Applicants many educational resources such as workshops and webinars as well as a detailed Accreditation Guide that outlines program standards and the requirements for each.  We offer an online Interpretations Portal for individuals with specific questions to get a detailed answer in writing from a URAC reviewer.  In addition, each Applicant is assigned an Account Manager as their URAC point-of-contact for guidance and questions.

How is accreditation recognized?

Organizations are provided accreditation certificates and are listed in the online URAC Directory of Recognized Companies.  Accredited organizations are provided a URAC seal to post on their website. 

How should I display my Accreditation Seal?

URAC makes available a Marketing Guide for clients with instructions on how to display the Accreditation Seal. We encourage you to proudly display it on your website, brochures, letterhead, even as part of your company’s email signature. The placement of the seal should accurately convey to customers and payers what portions of your business are URAC accredited.

What is a Monitoring Validation Review?

URAC conducts monitoring reviews mid-cycle to confirm continued compliance with the standards.  Organizations are selected by random sampling and are notified in advance.  These reviews are generally conducted virtually and there is no cost to the organization.

What is Measures Reporting?

Some URAC programs require annual reporting of measures by accredited organizations to demonstrate quality performance.  For more information go to the Measures Reporting web page.   

When should I submit a Notice of Change for my URAC-accredited program?

Accredited organizations are required to submit a Notice of Change to URAC within 30 days of completion of any material changes.  This includes, but is not limited to, change in ownership, change of corporate name, change of address, and addition or closure of sites, as well as any claim, proceeding, or investigation by a government or regulatory entity.

Is an accreditation transferable to another corporate entity in the event of a merger, acquisition in which the accreditation is no longer under control of the original applicant?

Accreditation is non-transferable. That said, we recognize that mergers, acquisitions, and sales are occurring in the health care industry daily. Once the change has taken place, an organization should submit a Notice of Change to URAC providing supporting information. URAC reserves the right to review the supporting information and determine next steps based on the unique circumstances of individual situations.

How can I request to add a new site to my existing accreditation?

Accredited organization may add a site by working with assigned Account Manager to sign an addendum and pay an applicable fee.  A Validation Review will be performed to confirm that the new site is compliant with the accreditation standards. 

How does URAC protect my patients’ Protected Health Information(PHI)?

URAC does not accept any documentation containing PHI.  During a Validation Review, the URAC reviewer may view PHI while observing operations, but will not capture or copy any PHI data.

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