The Basics

This standard applies only to prospective and concurrent reviews.  It requires that the UM organization base its review determination only on the information available at the time of the review.  While that may not make much sense out of context (how would you make the decision not based on the information available at the time of the review?), it makes more sense when you compare it to the next standard, which has a different rule for the information used for retrospective reviews.  Read together, the two standards make more sense.

Management Tips

This standard should be taken care of simply by a line or two in the P&Ps dealing with prospective and concurrent reviews.  Of course, it will make things easier if you also have a good method of tracking what information was used in the review and when it was available to you.  Scanning the documents with date-stamping will go a long way toward fulfilling that documentary requirement.  

URAC Accreditation Tips

This standard carries a weight of 4, and its sole element is primary.

For the desktop review, the P&P with the requisite language is all you will need to submit.