URAC accreditation ensures round the clock access to quality health care

Dec 2 2009

The spread of the H1N1 virus and the growing concerns about treatments have illustrated the need for reliable sources of health care information. URAC, the nation's leading health care accreditation and education organization, offers a Health Call Center Accreditation which provides a framework for call centers around the country. Accredited call centers have the right policies and procedures in place to respond to top public health concerns, including the H1N1 virus, and ensure that consumers get the information they need from licensed professionals - any time day or night.

"URAC accreditation provides quality assurance for consumers who are seeking information and guidance from health call centers, which is particularly important this flu season when there seems to be so much confusion," said Alan P. Spielman, President and CEO of URAC. "Consumers are better served by accredited call centers, as accreditation enables them to evaluate and measure their services and determine ways in which they can provide better care to consumers."

Forty-three health call centers across the country have passed the stringent quality measures set by URAC, which include a review of twenty-two different areas. Among the standards, a URAC-accredited health call center is required to provide consumers with access to a live registered nurse 24 hours a day; seven days a week and to utilize current clinical guidelines when assessing a consumer's condition that are approved by physicians. Questions regarding their health status are asked to determine the urgency for treatment, or whether a visit to the doctor or the emergency room is needed. Additionally, the consumer's physician can request notification of the consumer's call record for continuity of care purposes.

"URAC accreditation establishes a framework by which quality standards are maintained, giving piece of mind to consumers and customers," said Julie O'Brien, Vice President and COO of Alicare Medical Management, whose call centers have been accredited by URAC. "Forty percent of our Nurse Helpline calls this season have been related to H1N1. Callers know the services that are being delivered by Alicare Medical Management have an independent seal of quality, and that we are qualified to render the services we offer."

When an individual contacts a health call center to inquire about symptoms he or she is experiencing, the health call center takes the proper measures to direct the member to schedule a doctor's appointment if appropriate, visit an urgent care center or assist with calling emergency services to the consumer's location if the caller is unable to call on their own. URAC standards ensure that health call centers are able to respond to these issues quickly and with the appropriate clinical expertise, which ultimately reduces unnecessary emergency room and physician visits. There are also clear benchmarks for how quickly each call must be answered. Health call centers also provide health information about wellness activities and chronic health conditions.

"Call centers are an important lifeline for consumers who have questions after hours when their doctor's office is closed. URAC has robust requirements for accreditation, which keeps us in a place where we're constantly monitoring the quality of our programs," said Shalama Smith, Senior Quality Consultant, OptumHealth Care Solutions. "We don't sit still. URAC standards are a driver in that innovation."

SOURCE URAC