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.
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. Since then, we only ever use the acronym as our company name.
URAC’s independent approach to accreditation sets us apart. We rely on our multidisciplinary expert advisory groups from across health care to guide standard development. The result: programs with rigorous, evidence-based standards that set us apart as the “gold star” accreditor.
Accreditation is the process of rigorous review that allows health care organizations to demonstrate their ability to meet regulatory requirements and national standards established via a URAC stakeholder consensus process and recognized as key benchmarks for measuring the quality of an organization. Certification is a process of review that allows health care organizations to demonstrate competency in the provision of high-quality care and services conforming to specified requirements that may address a specific health care issue, disease or condition.
It varies for each accreditation and certification. You can find those details on each program page.
URAC's accreditation process timeline varies by program type, but our part of the process takes from four to six months. You can learn more about our process by watching this video:
We offer applicants many educational resources such as workshops and webinars as well as a detailed accreditation guide that outlines program standards and requirements. 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 a Client Relations Manager as their URAC point-of-contact for guidance and questions.
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.
The first step is to determine your eligibility for the specific program you wish to be accredited for. Once that is established, you receive a pricing quote, then sign an accreditation application agreement (AAA). You can connect with a URAC business development executive who can get you started by sending an email to email@example.com or calling 202-326-3943.
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.
Our team can help you find the right accreditation for your organization. Please contact us at firstname.lastname@example.org.
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.”
The fee structure is different for each of our programs. The application fee includes the desktop review, validation review, monitoring reviews, access to our 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 us at email@example.com.
We do not provide refunds for those organizations that do not earn 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.
Once an application is submitted, it usually takes about six months to complete an accreditation review and receive a determination.
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.
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.
You can find the most up-to-date information about our COVID response on our COVID news page.
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 a past life.
Yes, you can. However, we approve all extensions on a case-by-case basis. If you’re currently going through the application process, talk with your Client Relations Manager if you think you need an extension.
Provisional accreditation only applies to organizations that have not begun business operations, yet reflect compliance with URAC’s criteria through desktop review.
Our accreditation committee, comprised of multidisciplinary health care experts from accredited organizations, review blinded applications and make accreditation decisions.
Most accreditations are awarded for a period of three years.
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.
We have a marketing guide for clients that details 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.
We conduct monitoring reviews mid-cycle to confirm continued compliance with the standards. Organizations are selected by random and notified in advance. These reviews are generally conducted virtually with no cost to the organization.
Some of our programs require annual reporting of measures by accredited organizations to demonstrate quality performance. For more information, go to the Measurement web page.
You are required to submit a notice of change to us 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.
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 should submit to us a notice of change, providing supporting information. We reserve the right to review the supporting information and determine next steps based on the unique circumstances of individual situations.
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 standards.
We do not accept any documentation containing PHI. During a validation review, your URAC reviewer may view PHI while observing operations, but he or she will not capture or copy any PHI data.
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.
A few months before your current accreditation expires, your Client Relations Manager will reach out to you to sign a new accreditation application agreement (AAA) 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.
Reaccreditation involves the same process as your initial accreditation. You'll need to confirm your policies and procedures meet URAC standards. You will also have a desktop and validation review prior to receiving a decision on your accreditation status.