URAC’s Health Network Accreditation standards include key quality benchmarks for network management, provider credentialing, quality management and improvement, and consumer protection. URAC’s standards require health networks to establish self-monitoring practices, emphasizing quality assurance and improvement.
By achieving URAC’s Health Network Accreditation, organizations demonstrate that they have met URAC’s rigorous standards for quality and accountability.
The URAC-accredited health network:
- Complies with applicable laws and regulations where it conducts business
- Maintains a quality improvement program that includes measuring, monitoring, and evaluating services
- Ensures appropriate patient protections are established, including policies for confidentiality, informed consent, dispute resolution and other issues
- Emphasizes quality of care and quality of services in its provider selection criteria
- Meets requirements for provider dispute resolution mechanisms
- Implements a mechanism for participating provider suspension for consumer safety
- Verifies the professional qualifications of participating providers and facilities
- Meets rigorous requirements for a credentialing program
- Monitors participating providers’ continuing compliance with criteria for network participation
- Has a mechanism to conduct a consumer safety credentialing investigation when needed
- Can respond on an urgent basis to situations that pose an immediate threat to the health and safety of consumers
- Has a formal process to address consumer complaints in a timely manner
- And more.
Who may apply?
Preferred provider organizations, payer- and provider-based models, behavior health networks, specialty medical networks (e.g., radiologists, audiologists, dentists, physical therapists, optometrists, long-term care providers, etc.), physician-hospital organizations, chiropractic networks, workers’ compensation networks, and medical transportation providers may apply.