Payer Best Practices for Success: The healthcare industry is one of the most critical and rapidly evolving industries in the world. Healthcare payers, such as insurance companies, play an essential role in this industry by providing financial protection to individuals and families in the event of illness or injury.
NCQA Health Plan Accreditation program provides a framework for assessing the quality of health plans and ensuring that they meet certain standards.
NCQA Health Plan Accreditation is a rigorous evaluation process that assesses the quality of health plans and their ability to meet the needs of their members. As part of the accreditation process, NCQA requires health plans to undergo third-party review.
URAC accreditation consulting valuation begins with seeing the importance of earning a credential. The multifaceted world of accreditation can be daunting, from choosing the right accreditation body to getting correct documentation in place to ensure accreditation success.
An Independent Review Organization (IRO) deliver independent medical peer review services designed to ultimately reduce administrative costs and ensure patients receive proper treatments. Rising healthcare costs affect millions of people daily. Providers and insurers can rely on IROs to help them to control costs and offer affordable coverage.
BHM announced that it has been awarded re-accreditation as an Independent Review Organization from URAC
Level of Care Guidelines are usually derived from generally accepted standards of behavioral health practice. These standards include guidelines and consensus statements produced by professional specialty societies, as well as guidance from governmental sources such as CMS’ National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs).
Any serious discussion of patient care and cost containment must include a discussion about utilization review and management. Sometimes these two terms are used interchangeably, while their meanings and processes are quite different in reality.
Patient Centered Medical Homes (PCMH) value based care model growing across the United States. PCMHs aren’t actually places but care models based on providing care which is accessible, coordinated, and comprehensive. PCMHs focus on patient centered care and are committed to quality and safety.
The multifaceted world of accreditation can be daunting, from choosing the right accreditation body to getting correct documentation in place to ensure accreditation success. Here are 7 tips to keep you on track and lower first time accreditation risk.