Credentialing & Privileging

URAC approves revisions to UM standards

Credentialing Resource Center Connection , May 8, 2003

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The American Accreditation HealthCare Commission/URAC recently announced the approval of changes to its Health Utilization Management (UM) standards. The revisions put these standards in line with the Department of Labor's (DOL) new claims procedure regulation, especially in regards to acceptable time frames.

Specifically, the revisions now require managed care organizations (MCOs) to make non-urgent UM decisions within 15 calendar days, and urgent decisions within 72 hours. Previously, URAC standards measured time frames in business days, so this change forces MCOs to figure in weekends and holidays when making UM decisions. Visit www.urac.org/printrelease.asp?releaseid=177 for more information.



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