Acentra Health’s Independent Medical Review Division Earns Accreditation from Leading Care Quality and Safety Organization

December 05, 2024 at 11:54 AM EST

MCLEAN, Va., Dec. 05, 2024 (GLOBE NEWSWIRE) -- 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 Moore
Vice President, Corporate Communications
703-214-3552