The Basics

This standard requires that your organization have a means of allowing its clients to audit your organization's records to ensure that the disclosures your organization makes to the client regarding conflict of interest, revenue sources, and pricing structure (see CSCD 4) are complete and accurate.

With this standard, URAC intends to strike a balance between the client's legitimate need to audit with your organization's need to protect its proprietary business practices from disclosure to competitors.  To achieve this, URAC recommends that you design a method of selecting a mutually acceptable auditor.  One suggested approaches to offer the client a list of acceptable auditors from which it may choose.

Management Tips

This mechanism for providing audit rights to clients should be spelled out in a policy and procedure, as well as in your client agreements.  To make sure that, on the going forward basis, your agreements comply with the standard, it makes sense to develop a template client agreement that contains appropriate language regarding client audit rights.

URAC Accreditation Tips

The standard carries a weight of 4.

For the desktop review, simply submit a policy and procedure describing client audit rights as well as a template of a client contract that contains audit rights.

For the on-site review, be prepared to provide to the URAC reviewer a typical client contract that contains client audit rights.  We recommend that when you do so, you submit a copy that has deleted client identification and financial terms.