The Basics

This standard, unique to the Health Network module, allows a first- or second-time applicant a phase-in period during which the organization may credential all the participating providers in its network.  Here's how it works:

• There is no phase-in for practitioners, that is, as URAC defines the term, "An individual person who is licensed to deliver health care services without supervision."  In other words, all organizations must have all their practitioners credentialed by the onsite review.
• First-time applicants must have credentialed 50% of its participating providers (defined by URAC as entered into an agreement with the organization to be part of a provider network") within two years of first receiving accreditation in this program.
• Organizations taking advantage of this phase-in program must credential all of its participating providers within 3 years of its first accreditation under this program.

Management Tips

If you need to take advantage of the phase-in, what you will need to do is prepare a written credentialing plan that, when implemented, will be in compliance with the requirements of this standard.  Then, after accreditation, you'll need to submit reports every six months to URAC documenting your progress toward the goal.  Once you've achieved the goal of 100% of participating providers being credentialed, you need merely send URAC an attestation to that effect from senior management.

URAC Accreditation Tips 

All three elements of this standard are mandatory.

For the desktop review, submit an attestation from a member of the senior management team documenting the percentage of providers that are within the scope of the program that are credentialed per URAC standards.  Make sure the document provides two fractions:  (1) the percentage of practitioners who have been credentialed, and (2) the percentage of providers that have been credentialed.  If either of these numbers is less than 100 percent, also submit an implementation plan designed to bring your organization into compliance with this standard.

For the onsite review, be prepared to give the reviewer credentialing committee minutes from the past 4 years.  Be sure to include all attachments.  In addition, the reviewer will interview your credentialing department leadership for an update of the credentialing plan.