Navigation Links
New URAC Issue Brief Answers Questions About Delegated Credentialing, Transparency in Physician Tiering Programs
Date:6/17/2008

Brief will be released at AHIP Institute July 18-20

WASHINGTON, June 17 /PRNewswire-USNewswire/ -- A new issue brief from URAC provides answers for health plans and health networks wrestling with market demands for physician measurement and new trends in outsourcing of credentialing services.

(Logo: http://www.newscom.com/cgi-bin/prnh/20030501/URACLOGO )

The brief will become available during the AHIP Institute, June 18-20 in San Francisco. URAC is an AHIP exhibitor and will also be offering educational workshops for several of its accreditation programs during the Institute, including workshops for Health Network and Health Plan accreditations.

Health plans and health networks must balance the purchaser's need for assurance about the quality and efficiency of practitioners with the burden to provide broad access to desirable providers. URAC's standards surrounding provider credentialing help clarify how organizations can strike this balance in an environment where more companies are outsourcing credentialing services.

"URAC's standards require that the plan or network still is the party that renders the decision to allow the provider to participate in the network, even if the credentialing process itself is outsourced," said Christine Leyden, URAC's chief accreditation officer. "The delegated credentialing requirements ensure that plans and networks are still applying the same quality standards to their vendors' credentialing process and keeping consumer protection top-of-mind."

Most health plans and health networks still do the majority of credentialing in-house, although a growing number of organizations delegate credentialing by contracting with a qualified vendor to assist in the process. Vendors may be located either in the United States or abroad. According to both quantitative and qualitative research conducted by URAC in 2007, credentialing is among the top administrative functions currently outsourced by U.S.-based health care management organizations.

URAC-accredited health plans and health networks are still responsible for oversight and final approval of all providers even when they delegate the task to outside vendors. They are also responsible to continuously monitor network physician and provider performance so that a quality network is maintained.

The issue brief also outlines URAC's proposed new standards module for transparency in provider performance measurement. Regulatory interest in evaluating network tiering practices is on the rise, punctuated by the recent settlement statement by New York's Attorney General which sets out new parameters for the way that state's health plans can equitably measure and report physician performance. URAC's proposed module provides a means for accredited organizations to demonstrate necessary transparency in performance benchmarking practices.

The brief, "URAC's proposed revisions for health plan, health network standards answer market outsourcing trend and demands for measurement," can be downloaded by visiting URAC's web site at http://www.urac.org/savedfiles/JuneNewswebHealthNetworks.pdf

About URAC

URAC, an independent, nonprofit organization, is well-known as a leader in promoting health care quality through its accreditation and certification programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire health care industry. For more information, visit http://www.urac.org.


'/>"/>
SOURCE URAC
Copyright©2008 PR Newswire.
All rights reserved

Related medicine news :

1. American Red Cross Issues Appeal for Disaster Relief Fund
2. XL Capital Ltd Issues Statement Regarding Merrill Lynch Lawsuit Against XL Capital Assurance Inc. (XLCA) a Subsidiary of Security Capital Assurance Ltd
3. Tubbs Jones Addresses Health Disparities Issue During Hearing
4. BeaconEquity.com Issues TraderNotes on Medical Instruments and Supplies Stocks: LLSR, EMITF, BLTI, OISI, ACL, LMNX, MELA, PMII
5. Video: Zix Corporation Issues Statement Supporting Bipartisan Push for Medicare e-Prescribing Requirement
6. Leiner Health Products Issues Allergy Alert on Undeclared Allergens in Liquimax(R) Multivitamin
7. Genetic testing in newborns and children: Ethical issues affecting families and physicians
8. Economy, Health Care, and Gas Prices Top Issues for Women Business Owners
9. BME (BioMedical Enterprises, Inc.) Announces U.S. Launch of the OSSAnchor(TM) Grip Nitinol Soft Tissue Anchor
10. BeaconEquity.com Issues TraderNotes on Biotechnology Stocks: TPIM, RXII, VION, CUR, AMGN, GILD, BIIB, GENR
11. U.S.News 2008 Best Hospitals Issue Again Ranks Packard Childrens as One of Nations Best
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/7/2016)... ... December 07, 2016 , ... Children ... bodies, a researcher at the Icahn School of Medicine at Mount Sinai has ... found that when young children are exposed to secondhand marijuana smoke, measurable amounts ...
(Date:12/7/2016)... ... December 07, 2016 , ... ... acquired Presence Technology, S.L. (“Presence”) for a purchase price of approximately $17.4 ... other considerations. Presence’s annual revenue is approximately $13.2 million. Headquartered in Barcelona, ...
(Date:12/7/2016)... ... 2016 , ... A quote from Dr. Edward Hallowell, host of CRN International’s ... offer a rare glimpse into the mind of those people with ADHD. , Dr. ... author, has described people with ADHD as having “Ferrari engines for a brain, with ...
(Date:12/7/2016)... ... December 07, 2016 , ... ODU, a worldwide ... US market its advanced highly customizable contact technology solutions. , ODU Single Contact ... technologies are ideal for a wide range of applications that require customization from ...
(Date:12/7/2016)... ... December 07, 2016 , ... One of two inventors from Glen Burnie, ... is painful for her. "This is why the co-inventor and I have designed a ... They then created a prototype of the patent-pending AV-AIR, a device that serves as ...
Breaking Medicine News(10 mins):
(Date:12/7/2016)... 2016   Arena Pharmaceuticals, Inc. (NASDAQ: ... enrollment in the ralinepag phase 2 trial.  Ralinepag is ... pathway for the treatment of pulmonary arterial hypertension (PAH). ... "This marks an important step in the ... focus on our pipeline," said Amit Munshi , ...
(Date:12/7/2016)... Dec. 7, 2016 Diplomat Pharmacy, Inc. (NYSE: DPLO) has ... Homecare Federation, At-Home IV Infusion Professional, BioRx, MedPro Rx, and XAS ... services, visit diplomat.is/specialty-infusion .  ... Diplomat Specialty Pharmacy (PRNewsFoto/Diplomat Pharmacy, Inc.) ... "As we continue to build on the ...
(Date:12/7/2016)... , Dec. 7, 2016   Rx Savings Solutions ... and its Public Employees Insurance Agency (PEIA) to ... to their innovative healthcare software, ultimately saving money on their ... and provide its members with access to our software that ... more effective, affordable therapy can be found," says Michael ...
Breaking Medicine Technology: