URAC Core 1 -- Organizational Structure

Core 1 reads:

The organization has a clearly defined organizational structure outlining direct and indirect oversight responsibility throughout the organization. (Secondary)

This 3-weighted standard is rather straightforward and seldom the subject of a comment by URAC reviewers. Its purpose is to give the reviewer an understanding of the structure, ownership, and reporting mechanisms of the organization. The applicant should submit organizational charts at both the macro level (with senior organizational leadership described) and at the department level for the departments who are the subject of the accreditation under consideration. Additionally, organizational charts should show key committees, especially the Quality Management Committee and any other accreditation-relevant committees (e.g., credentialing committees for Health Plans and Health Networks). Any official company documents that describe the organization, particular the services that are the subject of the accreditation, will help, too.

If you submit these charts and program descriptions, you probably won't get any comments from the URAC reviewer. However, you may be asked for more information beyond this if there is something about the ownership structure that is unclear. For example, if you have a holding company or corporate affiliate, the name of which is all over your company documents but not reflected in the organizational charts, the reviewer may ask for some more detail.

The onsite review will simply be focused on making sure that what you said in the application is, in fact, the truth in practice. The interpretive guide says the following about the onsite review:

Recent (within past 6 months) reports demonstrating organizational oversight: reports will be analyzed along with any meeting minutes where they were presented and discussed

This review of reports and committee minutes, however, will be going on anyway in connection with other standards, so very little happens specifically and exclusively in connection with this standard.