LAKE FOREST, Ill. –
CoreSource, a leading national health plan administrator, has received Health Utilization Management Accreditation from URAC. URAC’s accreditation ensures that all types of organizations conducting utilization review follow a process that is clinically sound and respects patients’ and providers’ rights while giving payers reasonable guidelines to follow.
Utilization management (UM) is the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities under the provisions of the applicable health benefits plan, sometimes called “utilization review.”
URAC’s accreditation process involves a rigorous four-phase review: building the application, desktop review, on-site review, and committee review. URAC’s standards address the use of evidence-based guidelines, outline specific reviewer requirements for each level of review, and require a policy preventing financial incentives to doctors and other providers based on consumers’ use of health services; thus, the standards meet the demands of a changing health care system. URAC’s accreditation ensures the adequacy of health utilization management programs through evaluation against broadly recognized standards and measures.
“In today’s healthcare market, URAC accreditation provides a mark of distinction for organizations such as CoreSource to demonstrate their commitment to quality healthcare,” said Donna Heiser, Vice President, Healthcare Management. “CoreSource has been URAC accredited since 2001. We make sure to keep up this distinction because of our commitment to our clients who expect the most from our utilization management program.”
URAC is an independent, nonprofit healthcare accrediting organization dedicated to promoting healthcare quality through accreditation, education and measurement.
CoreSource is one of the nation’s leading health plan administrators, delivering integrated, customized employee benefit solutions to self-funded employers. The company maintains claims and customer service offices in Baltimore; Charlotte, N.C.; Chicago; Columbus, Ohio (NGS CoreSource); Detroit (NGS CoreSource); Kansas City, Kan.; Lancaster, Penn.; Tucson, Ariz.; and Little Rock, Ark. CoreSource is a subsidiary of Trustmark Companies, which celebrates more than 100 years of Trust. Visit www.coresource.com.