The largest online database anywhere of free accreditation advice for frontline and management employees in healthcare.
For well over a decade, we've been gathering what we know about accreditation standards and putting that knowledge into plain language. The product of those years of study and writing is this database of accreditation tips. Whenever we learn something new about a standard or the way the reviewers are interpreting it, we update our database.
Search the articles below. Get more accurate results by entering in the standard name or accreditation program.
The standard requires that your organization implement a means of addressing alleged violations by participating providers in its network of the organization's requirements for providers. The standard applies only to providers already in your network, not merely applicants for participation in the network.READ FULL POST
The standard is intended to address the situation of "silent PPOs". URAC provides the following definition and explanation of silent PPOs:[A] PPO brokers access to its provider network to other PPOs or payers without providers’ knowledge. For example, PPO X may sell access to its provider network to PPO Y. When an eligible person from PPO Y receives service from a physician in PPO X’s network, PP...READ FULL POST
This standard contemplates that not all of your existing contracts with participating providers contain all of the requirements of the previous several standards. Rather than forcing your organization to go back and amend all of the extant, noncompliant participating provider agreements, URAC allows you to "fix" to these agreements by using your provider manual or other similar document that descr...READ FULL POST
This standard was written to deal with the situation that might otherwise be considered delegation, as in the case where your organization contracts with a provider group that, in turn, contracts with an individual provider. Rather than subject that relationship to all of the requirements of delegation oversight, the standard simply says that your basic agreement with the provider organization mus...READ FULL POST
While the previous standard described what must not be in your provider agreements, this standard prescribes what must be in your provider agreements. It is a rather straightforward checklist:the names of the parties to the agreementminimum requirements for participating providersthe contractual obligations of both of the parties to the contractevents that may lead your organization to modify or t...READ FULL POST
This standard prohibits provider contracts from containing either a so-called "gag-clause" or a definition of UM that elevates cost and resource issues over clinical issues.READ FULL POST
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