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GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY AND GREAT-WEST HEALTHCARE OF CALIFORNIA RECEIVE URAC HEALTH UTILIZATION MANAGEMENT RE-ACCREDITATION
GREENWOOD VILLAGE, Colo., Nov. 14, 2005 — Great-West Life & Annuity Insurance Company and Great-West Healthcare of California recently received health utilization management re-accreditation from URAC, a Washington, D.C.-based health care accrediting organization that establishes quality standards for the health care industry.
The Great-West Life & Annuity Insurance Company accreditation is for the nationwide Great-West Healthcare Preferred Provider Organization (PPO) and Point of Service (POS) plans. The Great-West Healthcare of California accreditation is for the Health Maintenance Organization (HMO) plan in that state. Both have held health utilization management accreditation since 1997 and were re-accredited through July 2007.
“We are proud to have met URAC's rigorous accreditation standards,” said Terry Fouts, M.D., chief medical officer at Great-West Healthcare. “We are committed to ongoing quality improvement and providing customers with the best service possible. This accreditation provides independent, third-party validation of our practices.”
To achieve URAC accreditation, an organization undergoes a thorough evaluation of its processes and structures. It must first meet core standards, which are the foundation of URAC accreditation and serve as a prerequisite for accreditation modules. These standards address several key organizational functions, including: organizational structure; staff qualifications; training and management; oversight of delegated activities; quality management; and consumer protection.
URAC health utilization management accreditation requires that the organization establish and implement a three-step process to determine whether certain proposed medical treatments or services are medically necessary. The first step is the initial clinical review by a licensed health professional. Next, a physician qualified to render a clinical opinion about the proposed treatment or service performs a peer clinical review. In the final step, an appeal initiated by a patient or provider is considered by a qualified, board-certified physician in the same specialty not involved in the initial review decision. The process must be expedited, if requested.
URAC accreditation is granted by the accreditation and executive committees, which are composed of industry experts representing a broad range of health care stakeholders.
About Great-West Healthcare
Great-West Healthcare, a division of Great-West Life & Annuity Insurance Company, is a national employee benefits provider with expertise in self-funding and health care management solutions. Nationally, the division operates a health care network that includes more than 4,200 hospitals and 530,000 providers and provides health care coverage to nearly 2 million people. Visit www.greatwesthealthcare.com for more information.
Great-West Life & Annuity Insurance Company, headquartered in metro-Denver, serves its customers through a full range of health care plans, life and disability insurance, annuities, and retirement savings products and services. It is an indirect, wholly owned subsidiary of Great-West Lifeco Inc. and a member of the Power Financial Corporation group of companies. Great-West Life & Annuity Insurance Company is not licensed to do business in New York. Products are sold in New York by its subsidiary First Great-West Life & Annuity Insurance Company, White Plains, N.Y.
About URAC
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 establishing meaningful quality measures for the entire health care industry. For more information, visit www.urac.org.
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