Dr. Skip's Medical Peer Review Blog: The Importance of URAC
Friday, June 02, 2006
The Importance of URAC
AllMed Healthcare Management has been a URAC accredited independent review organization for almost five years. We’re very proud to have been one of the original IROs to seek accreditation under URAC. This accreditation now shared by other IROs is a mark of both commitment to quality and continuous improvement.
URAC accredited IROs have gone through the rigorous development and adhere to a core set of standards. They’ve also been through the process of improving their organizations, documenting their processes, procedures and policies and developing quality management and quality improvement projects in order to enhance the overall quality of their independent review process. As an independent review organization with URAC accreditation, we feel that URAC brings us significant credibility benefits. Many states have adopted URAC accreditation as one of the key guidelines for certifying or licensing an independent review organization in their state. Other companies have agreed only to do business with IROs that are URAC accredited. While URAC accreditation alone is not the sole mark of excellence in an IRO, it certainly is the foundation for creating a successful one.
URAC accreditation forces an organization to look at all of its processes and systems from a holistic perspective and to adopt a series of best practices in order to enhance its service delivery to its clients. An organization must not only adopt initial approaches relating to gaining accreditation but also assimilate them into a more permanent set of disciplines that ultimately shape the culture of an organization and lead it to excellence.
Our own experience with URAC accreditation has made our company better in so many ways…let me just list a few.
First, we have a rigorous system for tracking and improving our quality. Our quality management system is a driving force in our company. It helps us to constantly measure and monitor our performance relative to our past, as well as to set new goals and engage in a corporate attitude of continuous improvement.
Secondly, our URAC accreditation has helped us measure and monitor our performance and establish measures for client satisfaction, which we now routinely use to report, diagnose and resolve client problems should they arise.
Third, our URAC accreditation has allowed us to improve the rigorousness of our credentialing and recruiting process for recruiting specialists into our peer specialists panel and has lead us to be able to attract and retain some of the top specialists and sub-specialists in different key disciplines across the country. We also know when to shed physician reviewers who are not capable of meeting our quality and turn around time. URAC accreditation has also helped us to improve the overall planning and execution of our annual fiscal plans, as well as measuring and monitoring our performance against the rules that we set for our company.
So if your company is considering doing business with an IRO for the first time, or getting peer reviews or independent medical reviews done by an outside entity, make sure that you look for an organization that has gone through the rigorousness of a URAC accreditation process. While it’s not the only mark of quality, it certainly is a good way to separate wannabes from companies that truly have committed themselves to continuous improvement and excellence in providing decision making for health care and patient care.
