In addition to AppealTraining, the following websites contain useful information about assessing insurers for URAC compliance:
URAC Program Overview. This link takes you directly to the URAC page which explains the UR accreditation program and lists the carriers who have agreed to follow the standard.
http://www.urac.org/about_complaint1.asp. Complaints filed with URAC regarding noncompliant members will be investigated by URAC. Although URAC cannot resolve problems related to a health plan’s determination of benefits, URAC does have the authority to rescind the accreditation of noncompliant carriers. This leverage may assist you in dealing with noncompliant member organizations.
URAC Utilization Management Standards. This site contains the complete URAC utilization management standards which accredited organizations must follow if they render utilization management decisions. These are industry-wide standards for rendering quality UM decisions.
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