The Basics

The standard requires that your organization define the scope of the services it provides in three major respects:

• which distribution channels it offers (for example, the pharmacy network, any mail order pharmacies, or specialty pharmacies);
• what types of services it offers within each channel; and
• the geographic area that each channel serves.

In other words, you need to be able to communicate clearly what services you offer, how you offer them, and where you offer them.

Management Tips

It will be your responsibility to think through how you document each of the three components of this standard.  Documentation can come in many forms, including policies and procedures, marketing documents, regulatory documents, member or provider manuals, or reports that you provide to regulators or clients.  Just make sure that at least one document addresses each of these three elements.

URAC Accreditation Tips

Each of the elements of the standard issue is weighted 2.

For the desktop review, submit any appropriate combination of the geo-access analyses, regulatory submissions, or marketing documents.

The on-site review will focus on the interview with management personnel in the network management department in order to assess whether the managers are clear in their understanding of the organization's services, distribution channels, and service area.