Downers Grove, IL – Coventry Workers’ Comp Services recently announced that it has been awarded re-accreditation for its workers’ compensation case management and utilization review programs from URAC. URAC is a Washington, DC-based health care accrediting organization that establishes quality standards for the health care industry and grants certifications specific to workers’ comp programs. URAC’s Accreditation standards require companies to establish a process to assess, plan and implement case management and utilization review interventions.
“This URAC reaccreditation demonstrates Coventry’s commitment to providing quality services and serves as a framework for our business processes by benchmarking Coventry against nationally recognized standards,” said Betsy Robinson, Senior Vice President, product development and marketing for Coventry. “We are very pleased that our programs continue to be recognized for providing this level of quality, ethics and oversight.”
Coventry’s case management solutions advocate for appropriate, high-quality medical treatment while helping facilitate prompt return-to-work. They ensure that appropriate treatment and return-to-work plans are based on URAC guidelines that have been established and implemented specifically for work related injuries. The case managers work closely with the injured or disabled worker, treating providers, and the employer to facilitate timely and appropriate medical care and coordinate a safe and timely return-to-work that meets URAC requirements.
Coventry’s utilization review services include prospective, concurrent, and retrospective review of health care services based on medical necessity. Coventry’s utilization review program is available in 47 States (excluding MN, PA and OR), and with URAC accreditation, helps workers’ compensation payors address the increasingly complex regulatory environment in workers’ compensation, especially in those states where use of a URAC accredited Utilization Review program is required URAC’s Accreditation standards ensure appropriate patient protections have been established, 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.
“Coventry should be commended for continuing to meet strict quality standards,” said URAC President and CEO Kylanne Green. “It is critically important for healthcare organizations to make a commitment to quality and accountability. URAC accreditation is a demonstration of that commitment.”
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