NEW YORK--(BUSINESS WIRE)--New York-based healthcare review organization NYCHSRO/MedReview, Inc. has been granted URAC accreditation for its Independent Review (IRO) and Health Utilization Management (HUM) services.
A Washington-DC-based nonprofit organization, URAC has set the standard for the highest quality of healthcare and provided its imprimatur since 1996 to review organizations who meet nationally recognized criteria for the clinical and operational soundness of their utilization management process.
The three-year renewal follows a comprehensive audit of the firm’s operations by URAC representatives, which was fully virtual for the first time due to the continued COVID-19 pandemic. The accreditation renewal is effective June 2021 through June 2024 and is the fourth consecutive endorsement since 2012.
“We applaud NYCHSRO/MedReview on achieving URAC accreditation. With this distinction, NYCHSRO/MedReview demonstrates excellence in quality health care delivery and their commitment to ensuring patient safety,” said URAC President and CEO Shawn Griffin, M.D.
The accreditation pertains to two specific healthcare cost-containment services offered by NYCHSRO/MedReview:
- Health Utilization Management (HUM) assures the clinical and operational soundness of our health utilization management process by evaluating it against a stringent set of nationally recognized, evidence-based standards and measures. With URAC’s HUM standards, organizations maintain the highest confidentiality in UM processes to protect all parties–patients, providers, and payers.
- Independent Reviews (IRO) standardizes the clinical and operational approach and assures that IROs establish reviewer qualifications, are free from organizational or reviewer conflicts of interest, address medical necessity, and have reasonable timeframes for standard and expedited peer reviews and appeals processes.
Among NYCHSRO/MedReview’s many services to healthcare insurers, only our IRO and HUM programs are subject to URAC accreditation, however the qualification process involves every department of the organization from the executive suite to the mailroom and entailed hundreds of hours of staff time to complete.
Vice President of Legal Affairs Robert Rosenbloom and Vice President and Chief Medical Officer Seth Lewin, MD, oversaw the rigorous process, which commended NYCHSRO/MedReview “for its commitment to promoting quality health services by obtaining URAC accreditation.” CEO Spencer Young commented on the renewal process, “I’m proud to see our senior staff and many others rally around this project during these trying times. URAC accreditation in HUM and IRO is a testament to our discipline around process, clinical rigor, and our focus on deadlines.”
URAC’s healthcare accreditation process ensures that NYCHSRO/MedReview maintains its high operational standards and procedures at the level required for approval, which continues to add value to the entire organization. It is a symbol of excellence showing NYCHSRO/MedReview’s commitment to quality and accountability and demonstrates to current and future clients that we are forward-looking, service-oriented, and dedicated to providing the highest level of quality, efficiency, and service to their members.
“Each area of operation has to align its policies and procedures with URAC’s standards and submit them for scrutiny,” Dr. Lewin explained. “The right to continue to display the URAC seal is a proud achievement for NYCHSRO/MedReview, which continues to grow even through the pandemic.”
NYCHSRO/MedReview’s exceptional integration of medical expertise with business intelligence developed through 45 years in the field of claims audit and review is the cornerstone of this organization’s state-of-the-art operational efficiency and effectiveness on behalf of its clients.
MedReview, Inc. is a wholly owned subsidiary of New York County Health Services Review Organization (NYCHSRO), and a for-profit corporation, formed in 1984 to offer quality health care review, utilization management and analysis services to the private sector, including labor organizations, corporations, insurance companies, and managed care organizations.
In support of these efforts to ensure fair and accurate billing and payment to clients and providers while also monitoring the quality of care provided, MedReview has sought and been awarded both HITRUST certification since 2018 as well as URAC accreditation as an Independent Review Organization (IRO) and a Health Utilization Management (HUM) organization since 2012.
Founded in 1990 as a non-profit organization, URAC is the independent leader in promoting health care quality and patient safety through renowned accreditation programs. URAC develops its evidence-based standards in collaboration with a wide array of stakeholders and industry experts. The company’s portfolio of accreditation and certification programs span the health care industry, addressing health care management and operations, pharmacies, telehealth, health plans, medical practices and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.