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AQAF News

AQAF earns provisional URAC accreditation

AQAF earns provisional URAC accreditation

AQAF has earned provisional accreditation as a URAC Independent Review Organization: Comprehensive Review (Internal & External).

Independent review is a process, independent of all affected parties, used to determine whether a health care service is medically necessary and appropriate or experimental/investigational.

Independent review typically occurs (but not always) after all appeal mechanisms available within the health benefits plan have been exhausted. The review may be voluntary or mandated by law.

URAC’s Independent Review Organization (IRO) helps ensure that organizations that perform IRO services are free from conflicts of interest, establish qualifications for physician reviewers, address medical necessity and experimental treatment issues, and have reasonable time periods for standard and expedited reviews and appeals processes. URAC offers IRO accreditation for organizations conducting internal review (on behalf of the health benefits plan), external review (often mandated by state law), or both.

“By choosing to seek URAC accreditation, AQAF has displayed
leadership through a commitment to quality and accountability,” said URAC President and CEO Kylanne Green.

URAC, an independent, nonprofit organization, is a well-known leader in promoting healthcare quality through its accreditation, education, and measurement programs. URAC offers a wide range of quality benchmarking programs and services that model the rapid changes in the healthcare system and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire healthcare industry. For more information, visit www.urac.org.