How Exceedent Ensures Quality Health Care

how-exceedent-ensures-quality-health-care

Quality health care is a value Exceedent brings to member clients. Two ways we can ensure employers and their employees of our efforts to provide consistent quality care is through credentialing and accreditation. These efforts also confirm the efficient use of health care resources for Exceedent’s member employees.

Credentialing

Credentialing is the formal process of verifying that a physician or facility is qualified and competent to provide care. While Exceedent is ultimately responsible, we partner with a nationally respected credentialing firm that provides its expertise and efficiency to the process. Additionally, Exceedent will continually monitor the care of providers and health care facilities as part of its quality oversight program, using the data to decide whether to reappoint the providers and facilities every three years.

Accreditation

Exceedent has signed an agreement with Utilization Review Accreditation Commission (URAC) to pursue accreditation for both its health utilization management and the case management programs. Providing the Exceedent programs policies and procedures, URAC will review the documentation in detail and then investigate compliance. This spring, a trained URAC reviewer will be sent to examine how our nurse navigators and staff manage programs and interact with members, to make sure we are meeting or exceeding all of URAC’s national standards for accreditation.

URAC also accredits health content—educational materials we send to patients. Exceedent selects vendors who have or are pursuing URAC accreditation to assure educational materials meet the accreditation standards.

The accreditation process is targeted for completion by summer 2018.

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