NEW YORK, Sept. 14, 2012 /PRNewswire/ -- Two EmblemHealth companies, Group Health Incorporated (GHI) and HIP Health Plan of New York (HIP), have received Accreditation in Health Utilization Management for their commercial PPO products from URAC, a Washington, DC-based health care accrediting organization that establishes quality standards for the health care industry.
"We are honored that HIP and GHI products received Health Utilization Management Accreditation from URAC," said William Gillespie, MD, Chief Medical Officer for EmblemHealth. "This accreditation assures our patients, providers, purchasers, regulators and employers that our practices are fair and equitable for all parties."
The URAC Health Utilization Management standards establish constant standards to ensure that appropriately trained clinical personnel conduct and oversee the utilization review process, that a reasonable and timely appeals process is in place, and that medical decisions are based on valid clinical criteria.
"Quality health care is crucial to our nation's welfare, and it is important to have organizations that are willing to measure themselves against national standards," said Alan P. Spielman, URAC President and CEO. "By applying for and receiving Health Utilization Management Accreditation, EmblemHealth has demonstrated a commitment to quality health care."
EmblemHealth, Inc., through its companies Group Health Incorporated (GHI) and HIP Health Plan of New York (HIP), provides quality health care coverage and administrative services to approximately 2.8 million people. Groups and individuals can choose from a variety of PPO, EPO and HMO plans, as well as coverage for prescription drugs and dental and vision care. EmblemHealth offers a choice of networks, including quality doctors and other health care professionals throughout the region, leading acute care hospitals across the tristate area, and physicians and hospitals across all 50 states. For more information, visit www.emblemhealth.com.
URAC, an independent, nonprofit organization, is well-known as a leader in promoting health care quality through its accreditation and certification programs. URAC offers a wide range of quality benchmarking programs and services that keep pace with the rapid changes in the health care system, and provide a symbol of excellence for organizations to validate 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.