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Great-West Healthcare receives URAC accreditations for meeting quality standards
GREENWOOD VILLAGE, Colo., Oct. 15, 2007 – Great-West Healthcare, a national employee benefits provider, today announced it has been awarded provisional case management and full utilization management accreditation from URAC, a Washington, DC-based health care accrediting organization that establishes quality standards for the health care industry. The certifications are effective through May 1, 2008, and July 1, 2009, respectively. The carrier has held URAC’s health utilization management accreditation since 1997.
URAC’s case management accreditation standards require companies to establish a process to assess, plan and implement case management interventions. Its accreditation process reviews patient protections, such as policies for confidentiality of patient information, informed consent, dispute resolution and other issues. The standards cover staff structure and qualifications, quality improvement, information management, oversight of delegated functions, ethics, complaints and the case management process.
Great-West Healthcare case managers assist members nationally through high-cost or complex episodes of care. The program complements the carrier’s Member Champion program, in which customer service representatives provide telephonic support to help people during periods of complex medical care or administrative situations.
The URAC health utilization management standards establish consistency in this element of carrier operations. The standards ensure that appropriately trained clinical personnel conduct and oversee Great-West Healthcare’s utilization reviews, that a reasonable and timely appeals process is in place and that medical decisions are based on valid clinical criteria.
“Great-West Healthcare is honored to receive these accreditations from URAC,” said Terry Fouts, M.D., chief medical officer at Great-West Healthcare. “This independent, third-party validation underscores the quality of our work with customers, patients, clients and providers by demonstrating compliance with national standards for accountability.”
URAC accreditation required Great-West Healthcare to submit policies, procedures and other information, followed by an onsite review. Starting with standards development, select representatives from URAC’s 500-plus volunteer network gather to establish and revise benchmarks. These volunteers represent the interests of a wide variety of stakeholders including purchasers, regulators, consumers, providers and health care organizations. URAC standards are widely circulated for public comment and beta-tested. This broad, inclusive process helps ensure that URAC’s standards are balanced and address a diversity of needs and concerns.
About Great-West Healthcare®
Great-West Healthcare, a division of Great-West Life & Annuity Insurance Company, is a national employee benefits provider with expertise in self-funding and health care management solutions. Nationally, the division operates a health care network that includes more than 4,275 hospitals and 578,000 providers and provides health care services to 2.2 million people. Visit www.greatwesthealthcare.com for more information.
Great-West Life & Annuity Insurance Company, headquartered in metro-Denver, serves its customers through a full range of health care plans, life and disability insurance, annuities, and retirement savings products and services. It is an indirect, wholly owned subsidiary of Great-West Lifeco Inc. and a member of the Power Financial Corporation group of companies.
About URAC
URAC, an independent, nonprofit organization, is a leader in promoting health care quality through accreditation and certification programs. URAC's standards keep pace with the rapid changes in the health care system, and provide a mark of distinction for health care organizations to demonstrate 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 setting meaningful standards for the health care industry. For more information, visit www.urac.org.