Acentra Health’s Independent Medical Review Division Earns Accreditation from Leading Care Quality and Safety Organization
06 December 2024 - 3:54AM
Acentra Health, a technology and health solutions and services
company dedicated to accelerating better outcomes for its
government and commercial healthcare clients and the populations
they serve, announced that its Independent Medical Expert
Consulting Services (IMEDECS) division has earned URAC
accreditation as an Independent Review Organization (IRO), marking
24 years of full accreditation. This latest accreditation, for the
6.0: Comprehensive Review standards, demonstrates that IMEDECS has
the policies, procedures, and structure needed to deliver fair and
impartial peer-reviewed medical determinations that help its
clients improve health outcomes and operational efficiency.
URAC is the nation’s leading independent
accrediting organization committed to promoting health care quality
and patient safety through its accreditation and certification
programs. URAC develops its evidence-based standards in
collaboration with a wide array of stakeholders and industry
experts.
“We value the trust our clients place in Acentra
Health’s IMEDECS team to provide unbiased medical determinations,
which are grounded in evidence-based practices and a deep knowledge
of the medical literature, patients’ rights, and emerging
technologies,” said Todd Stottlemyer, CEO, Acentra Health. “URAC’s
accreditation affirms our commitment to providing our clients with
health services and solutions that improve outcomes with maximum
value and impact.”
IMEDECS works in all 50 states providing services
that include medical appeals review and independent dispute
resolution. Its diverse base of 600 clients includes federal and
state agencies, commercial health plans, and individual
organizations. With an experienced panel of over 500 medical
specialists, IMEDECS processes over 45,000 internal and external
appeals per year. Each case is matched by specialty to an actively
practicing board-certified physician to ensure accurate and
informed medical determinations. Its web-based portal provides
secure 24/7 access and has earned HITRUST’s certified status for
information security, underscoring Acentra Health’s commitment to
data privacy and cybersecurity.
Key services offered by IMEDECS include:
- Medical Necessity Reviews
- Coverage Determination Reviews
- Experimental/Investigational Review
- Quality Review
- DRG/Coding/Pre-Pay Review
- Coverage Policy Evaluations
“Acentra Health’s IMEDECS has been a recognized
leader for providing high quality reviews since 1999,” said Meghan
Harris, President and Chief Operations Officer, Acentra Health.
“Maintaining URAC accreditation for over two decades is a testament
to the deep expertise of the team, many of whom have been with
IMEDECS since its founding.”
“URAC’s Independent Review Organization
Accreditation validates that third-party organizations providing
medical determinations are committed to a fair and impartial peer
review process for all parties, including patients and physicians,”
said URAC’s President and CEO Shawn Griffin, MD. “We are proud to
recognize Acentra Health for maintaining high standards in the
areas of credentialing reviewers, review timelines, and decision
notification.”
URAC recognized Acentra Health’s Keystone Peer
Review Organization, LLC D/B/A IMEDECS at its Harrisburg, PA,
location for the Independent Review Organization Accreditation.
Keystone Peer Review Organization merged with CNSI and rebranded as
Acentra Health in 2023. Acentra Health also holds URAC
accreditations in Case Management, for its excellence in care
coordination; Disease Management, for effective prevention,
detection, and intervention of chronic diseases; and in Health
Utilization Management, for ensuring individuals receive
appropriate quality and cost-effective care in the right
setting.
IMEDECS’ URAC accreditation is valid through June
1, 2027.
About Acentra Health
Acentra Health combines public sector knowledge,
clinical expertise, and technological ingenuity to modernize the
healthcare experience for state, federal, and commercial partners,
and their priority populations. From designing and developing
advanced claims, encounter, and provider solutions that drive
efficiency and cost savings to delivering clinically focused
service models for care management and quality oversight, Acentra
Health is accelerating better health outcomes. Acentra Health is
backed by Carlyle (NASDAQ: CG), a global investment firm. Learn
more at acentra.com.
About URAC
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 spans 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.
urac.org.
Media Contact:Janice MooreVice
President, Corporate Communications703-214-3552
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