Everything you need to know to help with your accreditation process
Seeking accreditation is a big step for your organization. Whether this is your first time going through the process or you’ve been managing the accreditation process for your organization for years, undoubtedly you have questions. Here are the answers to the most commonly asked questions we hear.
Is URAC an acronym?
No, the proper usage of the URAC company name is only as URAC.
How are URAC standards developed?
URAC relies on multidisciplinary expert advisory groups from across health care to guide standard development and to inform the revision of existing programs. All new programs and revisions are posted for comment before release.
What are the different types of recognition programs URAC offers?
URAC offers accreditations, certifications and designations. Accreditation is a demonstration of high-quality processes and procedures to improve health care. Certifications are generally a demonstration of competence and quality in a specific area of health care. Designations sit on top of accreditations and demonstrate expertise in a niche area of health care aligned with the accreditation area.
Why is accreditation important?
In a complex industry, such as health care, there’s a lot at stake. It’s critical for everyone involved to meet national standards for quality, accountability, consumer protection and other key areas. The best way to do that is through accreditation by an independent third-party organization.
Why do organizations pursue URAC accreditation?
Our clients pursue accreditation for a variety of reasons. Accreditation may be a regulatory or network requirement. In some cases, accreditation may be able to boost the strength of an RFP. 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.”
What is the ROI of getting accreditation?
In addition to positively impacting the quality and safety of care, there are additional benefits that may help you grow your business.
- Your clients look for it. Payers and employers need to know their health care partners can provide high-quality services for their members and employees. As part of their RFP process, employers are starting to ask for certain accreditations.
- It’s a marketing tool to promote your capabilities. URAC ‘gold star’ accreditation puts you in an exclusive group of recognized health care leaders.
- It could help with reimbursement. Payers such as CMS may require accreditation to receive Medicare reimbursement.
- It could reduce risk. Because our standards focus on quality, safety and security, a URAC accreditation could help your organization minimize risk.
What are the eligibility criteria to achieve URAC accreditation or certification?
It varies for each accreditation and certification. You can find those details on each program page of the URAC website.
How do I get started with accreditation?
- Take the program quiz to determine which accreditations are right for your organization
- Download the standards
- Talk with one of our business development executives
- Sign the Accreditation Application Agreement and get ready to submit your documents
Or, connect directly with a URAC business development executive who can get you started by sending an email to businessdevelopment@urac.org or calling 202-326-3943.
We are a start-up. Can we apply for accreditation?
Provisional accreditation may be granted to organizations that have not begun business operations yet reflect compliance with URAC’s criteria through desktop review.
Does URAC accredit international (non-US) organizations? Where do you do business?
We primarily accredit organizations incorporated in the United States. However, our international accreditation services are growing with our digital health programs. We will be expanding into other accreditation services in the near future. Contact us to learn more about how we can help you become the “gold star” standard.
If an organization has removed any questions about the history of mental health or substance use disorder of their team members in job applications, are they still eligible to apply for a URAC accreditation?
URAC is proud to say that our standards have never required organizations to ask about the mental health of their care providers or other team members. In addition, URAC supports the Dr. Lorna Breen Heroes' Foundation in removing stigmatizing questions about mental health and substance use disorders in licensing applications, credentialing applications or other job applications and documentation for care providers and other team members. Organizations that do not include questions about the mental health of their team members may still be eligible to apply for accreditation with URAC (provided other requirements are met).
If an organization is based in a state that supports the removal of stigmatizing questions about a history of mental health conditions and substance use disorder for health care providers, are they still eligible to apply for a URAC accreditation?
URAC’s standards have never required states to ask questions about mental health or substance use disorder in licensure or credentialing. URAC fully supports the removal of stigmatizing questions about mental health in state licensure requirements for health care providers.
How long does the accreditation process take?
URAC's accreditation process timeline varies by program type. Once your organization submits your application, it usually takes about four to five months to complete the accreditation review and receive a determination.
Can I ask for an extension?
Yes, you can, however additional fees may be incurred. All extensions are approved on a case-by-case basis. If you’re currently going through the application process, talk with your Lead Reviewer or Client Relations Manager if you think you need an extension.
How long is the URAC accreditation cycle?
URAC's accreditations and certifications are awarded for a period of three years.
How much does URAC accreditation cost?
The fee structure is different for each of our programs and is based on factors like the size of your business and number of sites. Contact us at businessdevelopment@urac.org and we’ll figure out how much it will cost your business to go through URAC accreditation.
Is there a refund if we don’t earn the accreditation?
We do not provide refunds for those organizations that do not earn accreditation.
What are the parts of URAC’s accreditation application?
URAC’s accreditation process consists of the application submission, a desktop review of documents, up to two rounds of requests for information, an in-person or virtual validation review, the decision about your application and ongoing monitoring. You can learn more about URAC’s accreditation process here.
How are accreditation and certification decisions made?
Our Accreditation Committee, comprised of multidisciplinary health care experts, represent URAC’s program product lines and may be from accredited or certified organizations, and/or possess expertise in the healthcare and technology industries. They are responsible for reviewing blinded applications and making accreditation decisions on every application.
What is a monitoring validation review?
We conduct monitoring reviews mid-cycle to confirm continued compliance with the standards. Organizations are selected at random and notified in advance. These reviews are generally conducted virtually with no cost to the organization.
What resources are available to applicants?
URAC offers several resources to clients including a detailed accreditation guide that outlines program standards and requirements (sent from a Sales Executive upon signing a contract), a Client Information Hub with tools and tips for applying for accreditation, monthly webinars on using URAC’s application system, and a standards interpretations portal to submit and receive answers to your questions about a specific standard. In addition, URAC assigns each organization a Client Relations Manager as their URAC point-of-contact for guidance and questions.
How are accredited and certified organizations recognized? And how do you help us market our accreditation or certification?
URAC provides organizations with a mailed paper certificate. In addition, we list accredited organizations in our online directory. We also provide a URAC seal to post on your organization’s website and post congratulations to organizations that earn an accreditation or certification on LinkedIn, Facebook and X/Twitter.
What is measure reporting?
Some of our programs require annual reporting of measures by accredited organizations to demonstrate quality performance. For more information, go to the Measurement page.
How should I display my accreditation seal?
There is a Client Marketing Guide with detailed instructions on how to display the accreditation seal. We encourage accredited organizations 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.
When should I submit a “notice of change” for my URAC-accredited program?
You are required to submit a notice of change to us within 30 days after completion of any material changes. This includes, but is not limited to, change in ownership, change of corporate name, change of address, 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 daily in the health care industry. Once the change has taken place, an organization must submit a notice of change and provide supporting information. We reserve 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?
You may add a site by working with your assigned Client Relations Manager to sign an addendum and pay an applicable fee. We’ll perform a validation review to confirm that the new site is compliant with the accreditation program standards.
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. We've seen that the best way to make the process flow more smoothly is when we're able to talk directly with the people who are in charge of operations, quality and outcomes.
Does URAC endorse specific consultants?
We do 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.
Who are URAC’s accreditation reviewers?
We are 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 previous professional roles.
How do I start the reaccreditation process?
Several months before your current accreditation expires, your Client Relations Manager will reach out to you to sign a new Accreditation Application Agreement (your contract with URAC) and get you started on the next cycle. We will work with you to make sure everything is in place so that your accreditation doesn't expire between cycles.
What does reaccreditation involve?
Reaccreditation involves the same process as your initial accreditation. You'll need to provide your organization’s current policies, processes and procedures, etc., that demonstrate compliance to URAC standards. You will participate in a desktop and validation review prior to receiving a decision on your accreditation status.
How does URAC protect my patients’ Protected Health Information (PHI)?
URAC does not request or accept documentation containing PHI. During a validation review, your URAC reviewer may view PHI while observing operations, but the reviewer will not capture or copy any PHI data.
