The Basics

This is a straightforward standard with two components:  

• The first requires the organization to implement a policy and procedure requiring its UM staff members to identify themselves by name, title, and the name of the organization.  This requirement must apply in all interactions between staff members and outsiders, whether in person or by phone.  
• The second requirement is that the organization's P&Ps mandate that their staff members provide information about UM requirements and procedures, on request, to patients, healthcare providers, and others involved in the UM process.

Management Tips

Note that your staff members need not disclose a last name.  Furthermore, if the caller encounters an introductory message on the way into your phone system that identifies your organization by name, your UM staff members do not need to repeat that information.  

URAC Accreditation Tips

This standard is weighted 3, and both elements are secondary.

The documentation required for this is not only the obligatory P&P, but also evidence of its implementation, such as scripts for UM staff members and/or badges for concurrent review nurses.  For the onsite review, in addition to having those documents available for the reviewer, the UM staff members should expect either to be asked about how they identify themselves or to simply be observed in the performance of their duties to see if they do, in fact, comply with the P&P and this standard.