URAC P-CR 17 & N-CR 17 -- v. 5.1 Proposed Revision -- Credentialing Delegation

The existing standard CR 17 for both Health Plan and Health Network reads:

The organization complies with the Core Standards for any credentialing functions it delegates to another entity. In addition, the organization: (Secondary)
(a) Retains authority to make the final credentialing determination regarding any provider; and (Primary)
(b) At least every three years, conducts surveys of each entity that performs credentialing functions on behalf of the organization. (Secondary)

The proposed revision would change (b), leaving the standard to read:

The organization complies with the Core Standards for any credentialing functions it delegates to another entity. In addition, the organization: [--]
(a) Retains authority to make the final credentialing determination regarding any provider; [M]
(b) At least every three years, conducts an onsite survey of each entity that performs credentialing functions on behalf of the organization or if not conducting the survey onsite, then randomly requested credentialing files are sent to the organization within 24 hours of the request. [4]

As the interpretive information explains, the purpose of this change is "to indicate that in lieu of an onsite survey for conducting oversight of delegated entities for credentialing, the organization may randomly select credentialing files to be sent to it within 24 hours of the request."  

The word "survey", used here and in Core 17 , also dealing with delegation, has always been a bit confusing to some URAC applicants.  This language addresses that confusion head-on, at least for delegation of credentialing.  The term remains undefined for other forms of delegation, however, and I wouldn't be surprised to see the Core delegation standards amended in some future version along the lines of this revision.