Is your organization considering a URAC accreditation but finding yourselves stuck on writing policies and procedures
If so, the URAC team is here to help. In this webinar, we review why policies and procedures are important to an organization, the basics of writing P&Ps that work for your organization and what URAC looks for in policies and procedures you submit as part of your accreditation application.
Questions from the webinars and their answers
How often are organizations required to update their policies to maintain compliance with URAC standards?URAC standards require a review of policies and processes at least every 36 months.
What elements are absolutely required as sections in a company procedure? I've seen differences between organizations. Examples: Objective, Responsibility, Scope, Process, Approvals, Revision #, Revision History.
Organizations should use a policy template that includes elements that are meaningful to their organization. There are many templates online that can be used as a model. At a minimum the following should be included to comply with URAC standards: effective dates, review dates, revision dates and identification of approval authority.
What's the best method for organizations with multiple accrediting organizations? Is it better for pharmacies to have the same policy but with versions that have language matching the accrediting body or have one policy that reflects the organization’s needs?
First and foremost, policies and procedures should document an organization’s rules of conduct and guide standardization of the staff’s daily operational activities. Secondarily, policies and procedures may be used to demonstrate compliance with accreditation or regulatory standards. It is best practice to maintain one set of policies and procedures versus multiple. This promotes understanding and utilization of these important documents.
When URAC standards change (from one version to another) and an organization updates policies, when should they implement the revised policy?
Organizations should maintain compliance with the program standards they are currently accredited under until they submit their reaccreditation application. URAC expects compliance with the revised standards as of the date the reaccreditation application for the new program version is submitted.
If an organization uses a vendor for claims adjudication, can they submit their policies as-is? Or do they need to rewrite them verbatim in the company’s template?
If an organization delegates a function within the scope of the accreditation, the organization is responsible for ensuring the vendor complies with URAC standards. During the accreditation review process, URAC will review how the organization conducts oversight of the vendor to ensure compliance with URAC standards. URAC will not review the specific policies and procedures of the vendor. As such, an organization who delegates a function does not need to submit policies and procedures specific to that function to URAC on Desktop Review. Rather the organization can upload documentation indicating the function is delegated.