Management Tips

As you know, URAC has specific requirements for staff training that relate both to the content of staff training and its administration.  The Medicare Advantage component of those requirements related to confidentiality are addressed here.:

Content

Your organization must implement a training program to protect member confidentiality.

Administration

There must be documentation of all training provided for staff.

There must be a signed document acknowledging training on confidentiality issues.

The confidentiality training requirement is company-wide.  Company-wide training is typically handled either through:

• company-wide meetings
• computer-based training modules required of all employees, or
• smaller, face-to-face trainings required of all employees. 

URAC Accreditation Tips

The element requiring training in confidentiality standards is mandatory.  The rest are either weighted 2 or 4.p

The best preparation for the URAC review is the substantive training described in the previous section.  A staff member who knows his/her job as described by the applicable P&Ps, knows the URAC standards that apply to the job, and can retrieve the documents to be sought by the URAC reviewer is unlikely to get tripped up in a URAC review, even if they have no specific preparation for the onsite review process.

Additionally, the mock onsite review we conduct for our clients is valuable for staff members likely to be either interviewed or pulling documents during the onsite review.  We spend a good portion of our time onsite not only conducting document-pulls and interviews as realistically as possible, but also counseling staff members on how to improve their performance for the actual review.

Documentation for the desktop review should include training and education program outlines and agendas across the organization, as well as any tools you use in training.

For the onsite review, be prepared to produce comprehensive orientation and training materials for selected staff members.  In addition, at any point during the on-site review, the reviewer is likely to ask the staff member about his or her training across the full scope of the standard's requirements.