Provisional accreditation: what the 18 months are for
Provisional accreditation is URAC's route for a start-up that has yet to open for business. The 18 months that follow are for getting business, and then for the review that checks your policies are what you do.
As I explain it, the 18 months of URAC Provisional accreditation are for two things, in order. First, you go out and get business. Then URAC comes back and validates that the policies it approved are what you actually do. Provisional is an accreditation, and it rests only on the documents URAC's reviewers have read. What makes it provisional is that no one has yet checked that those policies are implemented.
Why Provisional exists
A start-up has a catch-22. It needs accreditation to get clients, and the accreditor needs to see it handling clients before it will accredit. Provisional is URAC's answer. I was there when we invented this. The program is designed specifically for start-ups.
In my account, the first stage is the documents: the policies, plus supplementary material such as committee meeting minutes and reports. At Provisional there are fewer supplementary documents. An applicant for Provisional does not need to have begun reviews; it needs the documents required for desktop review, including at least one compliance audit that does not rely on having business. Auditing your reviewer credentialing process is an example. The validation review, the step up to Full, comes only after the business is up and running.
URAC's FAQ answers the start-up question with Provisional (read Nov 2, 2026: https://www.urac.org/accreditations-certifications/accreditation-faqs/). That page gives no length for Provisional and does not describe the route to Full. The length, the stages and the outcomes in this article are my account.
Provisional is distinctly a URAC construct. Other accreditors have their own ways of handling start-ups, and I do not presume to know them. If you are weighing accreditors, that is research you would have to do.
What the 18 months are for
The first job is to go out and get business, signing clients and serving them so that there is activity to show. The second job is the validation review. Once there is enough client or consumer activity to validate, URAC comes back, on site or virtually. In my account that review has to happen inside the 18 months, and either the organization or URAC can decide that it is time.
What URAC is checking when it validates the company, in my words:
[...] its policies aren't a Potemkin village, aren't a [...] sham, but in fact, are what they are doing, as they relate to clients and consumers and providers.
As I explain it, the three main stakeholders are clients, consumers and providers. In my reading, a policy set can read perfectly and still describe a company that does not exist, and the validation review is where URAC finds out which kind of company it is looking at.
Using the months
In my reading, the months are best spent on the evidence the validation review will ask for. The people who do the work need to know what the policies say and be able to show the records that prove they did it. The committees the policies describe need to meet, and their minutes need to accumulate. Until there is enough client or consumer activity, the validation review has little to examine, so part of the work in these months is producing it.
The review is the regular one, postponed
The review that follows Provisional is, in my words,
[...] identical to the regular validation review, just postponed.
In my account, if the reviewers are satisfied that the policies have been implemented, they recommend to URAC's accreditation committee that the status be upgraded from Provisional to Full. After Full, in my account, the organization works toward its next accreditation date, and the process starts again, perhaps under a new set of standards.
What the review can decide
As I explain it, a validation review leads to one of four decisions: full accreditation, conditional accreditation, corrective action or denial. The first two are accreditations. Corrective action is not, and in my account gives you three to six months to correct. URAC's process page lists Provisional among its determinations as well, and that is the start-up decision this article is about (read Nov 2, 2026: https://www.urac.org/accreditations-certifications/accreditation-process/). The same page says any result short of full accreditation can be appealed.
In my account a denial essentially prohibits the organization from applying again for another year, and the review cycle that follows adds months, so a denial can set an organization back about 18 months.
Timing the Provisional decision
In my account the 18 months run from the Provisional decision, not from your first client. When opening is fixed by something outside your control, such as a regulatory review, plan the timing before you sign the URAC agreement, aiming for a Provisional decision close to opening. In my account URAC gives every applicant a deadline for submitting documents for desktop review through AccreditNet when the agreement is signed, so the timing needs planning before you sign. A decision that arrives much earlier can run the clock out before there is enough operating history for the move to Full to look at. The policy work does not wait on that timing and can start now. After you submit the documents, the schedule is URAC's, so leave room. How the document stage runs, from the agreement through desktop review to the committee, is a subject for a separate article.
Where organizations go wrong in the 18 months
They lose track of the policies URAC approved. One way is the client request. In the course of winning a client, the organization is asked to do something that does not comply with URAC's standards, and it complies with the client. The approved policy says one thing and the practice says another, and the validation review is built to find that gap.
The other way is new staff. Someone who joins after the Provisional decision does not know the accreditation requirements and changes a policy without looking at the standard that made it read the way it does. The approved wording was written to meet a requirement, and when the wording changes the provision that met the requirement may go with it.
What do people ask about Provisional accreditation?
Who can get Provisional accreditation?
In my account Provisional is for start-ups that have no clients yet. The URAC FAQ points an organization that has yet to open for business to it as well.
What do I need before the Provisional desktop review?
As I explain it, you need only the documents required for desktop review, including at least one compliance audit that does not rely on having business. You do not need to have begun reviews, and you do not need clients. Evidence drawn from serving clients belongs to the validation review that comes later.
How long does Provisional accreditation last?
In my account, Provisional lasts 18 months, counted from the Provisional decision. The URAC FAQ page gives no length for Provisional.
What comes after Provisional?
In my account, a validation review comes next. It is the regular validation review, postponed, so it can lead to the same four decisions, and it has to happen inside the 18 months. If the reviewers are satisfied, they recommend that URAC's accreditation committee upgrade the status to Full, and the accreditation process repeats for the next accreditation.
What are the four decisions after a validation review?
As I explain it, a validation review leads to one of four decisions: full accreditation and conditional accreditation, which are accreditations, and corrective action and denial, which are not. In my account, corrective action gives you three to six months to correct whatever kept the result below an accreditation decision.