Understanding the process of attaining URAC accreditation

CareWorks is excited to continue to earn accreditation from URAC.

The URAC Case Management standards apply to organizations that provide telephonic and/or on-site case management services in conjunction with a benefits program that is privately or publicly funded. There are 33 standards which comprise the URAC accreditation program and we are proud to know that we were successful in earning the full two-year accreditation with our initial application.

We are proud of our success and want to share with you some detailed information about achieving URAC accreditation.

Who is URAC and What Do They Do? The American Accreditation HealthCare Commission/URAC was founded in 1990 as a 501 (c) (3) non-profit organization to create standards for the managed care industry. Their initial focus was creating industry standards for utilization management.

Since that time, URAC has established standards for the following managed care accreditation programs:

  Health Utilization Management
  Health Plan
  Health Network
  Health Provider Credentialing
  Credentials Verification Organization
  Health Call Center
  Workers' Compensation Utilization Management
  Workers' Compensation Network
  Case Management Organization
  External Review Organization
  Core Organizational Quality Standards

integrated disability managementURAC accreditation standards are developed through a committee process with input from URAC's broad-based membership. This includes representation from all stakeholders affected by managed care, such as employers, consumers, regulators, health care providers, and workers' compensation and managed care industries.

URAC solicits public comments during the standards development process and conducts "beta" testing of the standards with managed care organizations before the Board of Directors approves the final standards.

American Accreditation HealthCare Commission/URAC Members

American Association of Health Plans
American Association of PPOs
American College of Physicians/American Society of Internal Medicine
American Health Quality Association
American Hospital Association
American Insurance Association
American Medical Association
American Nurses Association
American Psychiatric Association
Blue Cross and Blue Shield Association
Health Insurance Association of America
International Union, UAW 
Managed Health Care Association
National Association of Insurance Commissioners
National Association of Manufacturers
Case Management Washington Business Group on Health

Accreditation by URAC is an indication that a managed care organization has the necessary structure and processes to promote high quality care and preserve patient rights. A number of states recognize URAC accreditation standards in their regulatory process.