The Basics

The standard requires that your DTM program be designed so that it may be integrated with your purchaser's existing offerings.  Specifically, not only must the program integrate with those health and service offerings, it must also have the capacity to coordinate communications, materials distribution, and other procedures with those offerings.

The standard requires that your organization be cognizant of your purchaser's existing programs, which might include insurers, PBM's, TPAs, and DM vendors.  It will be important that you know how your DTM program shares information with all of these entities.

Management Tips

Management's primary obligation is to make sure that this integration is explicitly described in your program description or policies and procedures.  In addition, you will need to make sure that your employees are trained in how the integration works in your organization.

URAC Accreditation Tips

The three elements of the standard are each weighted 3.

The DTM program description or applicable policies and procedures, explicitly outlining mechanisms for integration with the purchaser's health and service offerings, is all that you need to submit at the desktop review level.

During the on-site review, the reviewer will both talk to staff members in the program manager and take a random sample of the program participant records to make sure that this integration is ask the being implemented with individual consumers.