2018 UM/CR/Provider Network Standards and Guidelines (epub)

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2018 Standards and Guidelines for Accreditation in Utilization Management and Credentialing and Provider Network
Effective for surveys with a start date of July 1, 2018 onward.

This publication outlines standards and features explanations and examples of how to meet the standards, scoring guidelines, points and certification outcomes. Eligibility requirements, application information and policies and procedures are also included.

Note: Purchase of the Standards and Guidelines is not necessary when purchasing the Survey Tool.