URAC Health Contact Center Accreditation — Frequently Asked Questions
Last updated: April 2026
Answers to the questions IHS hears most often from nurse advice lines, health plan call centers, and clinical contact centers evaluating URAC Health Contact Center Accreditation. Thomas G. Goddard, JD, PhD, former Chief Operating Officer and General Counsel of URAC, leads every IHS engagement.
What is URAC Health Contact Center Accreditation?
URAC Health Contact Center Accreditation is a nationally recognized quality credential for organizations that provide health-related services to consumers through telephone, live chat, email, or text. The program validates that a contact center's operations, staffing, clinical protocols, technology, and quality improvement activities meet defined national standards.
The program has two modules: the Clinical Contact Center module for organizations performing nurse triage and licensed-clinical-staff-led health support, and the Non-Clinical Contact Center module (NCP, currently Version 6.0) for organizations providing administrative services such as appointment scheduling, referrals, billing support, and member services. Accreditation is valid for three years.
Who is eligible for URAC Health Contact Center Accreditation?
Any organization that performs health triage and clinical support services, or non-clinical administrative support services for healthcare organizations, is eligible. Eligible organizations include:
- Nurse advice lines and nurse triage services
- Health plan and managed care member services contact centers
- Disease management and care coordination call centers
- Telehealth intake and navigation centers
- Third-party administrators (TPAs) providing health contact center services
- BPO vendors contracting with health plans for member communication services
- Medicaid managed care contact centers subject to state accreditation requirements
What is the difference between the Clinical and Non-Clinical Contact Center modules?
The Clinical Contact Center module applies when licensed registered nurses or other clinical professionals perform health triage, clinical advice, or clinical support. The classic example is a nurse advice line — members call with health concerns and a registered nurse performs triage using clinical protocols. This module requires 24/7/365 RN availability, evidence-based clinical guidelines, clinical oversight of non-clinical staff, and triage outcome tracking.
The Non-Clinical Contact Center module (NCP, Version 6.0) applies when the organization provides administrative support — scheduling, referrals, billing, prior authorization intake, member services — without clinical triage. Both modules share URAC CORE standards covering operations, consumer protection, staff training, quality improvement, technology, and information protection. Organizations may apply for either or both modules simultaneously.
What are URAC's telephone performance thresholds for health contact centers?
URAC defines specific, measurable thresholds that accredited health contact centers must meet and document:
- Average speed of answer by a live person: within 30 seconds
- Call abandonment rate: 5% or less
- Callbacks: completed within an average of 30 minutes
- Clinical Contact Centers: 24-hour, 365-day access to licensed registered nurses
These thresholds must be demonstrated with ongoing operational performance data — not simply asserted in policy. Organizations without existing performance reporting infrastructure need to build it before applying.
How long does URAC Health Contact Center Accreditation take?
URAC states that organizations can achieve accreditation within six months or fewer from completed application submission. The preparation work before application — gap analysis, policy development, protocol alignment, and documentation — typically adds 2–4 months for operationally ready organizations, and 6–12 months for organizations with significant gaps. The full realistic timeline from initial gap analysis to committee decision is 6–12 months depending on operational readiness at the start.
What does URAC's accreditation process look like step by step?
URAC's formal accreditation process has four stages:
- Application: The organization obtains the applicable standards, confirms eligibility with URAC, completes preparation, and submits the formal application with supporting documentation.
- Desktop Review: URAC reviewers examine submitted policies, procedures, and evidence against the applicable standards. Requests for Information (RFIs) may be issued at this stage.
- On-Site or Virtual Review: URAC reviewers conduct staff interviews, operational review, and technology assessment.
- Committee Decision: URAC's accreditation committee issues the final accreditation determination. RFIs may also be issued post-review, requiring responses within URAC's specified windows.
What are the most common reasons organizations fail URAC Health Contact Center review?
The most consistent failure points IHS sees in organizations approaching review unprepared:
- Telephone performance data gaps: Metrics not meeting thresholds, or performance data not documented in a format reviewers can verify
- Outdated or undocumented clinical guidelines: Guidelines licensed but not operationally integrated, or not reviewed and updated on a defined schedule
- Incomplete staff training records: Training curricula exist but competency validation records are missing or not maintained per individual
- Quality improvement programs that exist on paper only: No measurable goals, no documented improvement cycles, no trend data
- Consumer protection gaps: Missing grievance pathways, inadequate privacy notices, or non-discrimination documentation absent
- 24/7 RN coverage not documentable: Clinical Contact Centers that assert 24/7 coverage but cannot produce scheduling records demonstrating it
- Information protection policies that do not cover all channels: Organizations that added chat or text channels but did not update HIPAA-aligned information protection policies to address them
Does URAC Health Contact Center Accreditation cover digital communication channels?
Yes. The program explicitly covers organizations operating across multiple communication channels — telephone, live chat, email, and text. Standards apply to the organization's full operational footprint. Organizations using multiple channels must demonstrate that performance metrics, consumer protection practices, and information security policies address all channels — not just telephone.
Can a non-clinical contact center get URAC accreditation if it does not employ nurses?
Yes. The Non-Clinical Contact Center module is designed for exactly this situation. Administrative contact centers providing scheduling, referrals, billing support, prior authorization intake, and member services do not need clinical staff to pursue NCP accreditation. The NCP module does require that non-clinical staff have a defined escalation pathway to clinical resources when a consumer presents with a clinical concern — but the organization itself does not need to be a clinical operation.
What clinical guidelines must a URAC-accredited clinical contact center use?
URAC requires established, evidence-based clinical guidelines and decision-support pathways — but does not mandate a specific product. The most commonly used systems in URAC-accredited clinical contact centers are Schmitt-Thompson Clinical Content (the dominant nurse triage guideline platform), MCG Health (Milliman Care Guidelines), and equivalent nationally recognized nurse triage protocols. The key requirement is that guidelines must be current, reviewed on a documented schedule, and operationally integrated into triage workflows — not simply licensed and installed on a server.
What is the NCP Version 6.0?
The Non-Clinical Contact Center module, Version 6.0, is the current standards version for non-clinical administrative contact centers. Version 6.0 reflects updates to URAC's CORE standards framework with modernized requirements for technology use, information security, and consumer protection — particularly as contact centers have expanded into digital channels. Organizations applying today are evaluated against Version 6.0. Organizations re-accrediting under prior versions must update documentation to meet current Version 6.0 requirements.
How does URAC Health Contact Center Accreditation relate to other URAC programs?
Many contact center organizations simultaneously hold or pursue other URAC accreditations — most commonly Health Utilization Management, Case Management, Disease Management, and Telehealth. URAC allows organizations to add accreditations during an active three-year cycle without restarting. Because the Health Contact Center standards share CORE standards with other URAC programs, organizations with existing URAC accreditations have a documentation foundation to build from. IHS coordinates multi-program URAC strategies to avoid duplicating work across programs.
How much does URAC Health Contact Center Accreditation cost?
URAC application and accreditation fees are not publicly published and vary by organization size, module selection, and program configuration. Contact URAC directly for current fee schedules. IHS consulting engagement fees are scoped per engagement based on module selection, operational readiness, and timeline — contact IHS for a tailored proposal.
Can an organization pursue both Clinical and Non-Clinical modules at the same time?
Yes. URAC allows simultaneous application for both modules. This is common for health plan contact centers operating a nurse advice line alongside administrative member services under the same operational structure. Pursuing both modules simultaneously is more efficient than sequential applications because shared CORE standards documentation is developed once and applied to both tracks — reducing total preparation time and cost.
What ongoing requirements apply after accreditation is awarded?
Accreditation is valid for three years. During the active cycle, organizations must maintain ongoing compliance with all applicable standards: continuous telephone performance monitoring and documentation, regular clinical guideline review and update, ongoing staff training and competency validation, active quality improvement programs generating measurable data, and current information protection practices covering all communication channels. Significant operational changes — adding channels, expanding clinical service lines, onboarding new health plan clients — may require URAC notification. IHS provides ongoing advisory support during the accreditation cycle to manage these requirements before they become deficiencies.
Questions Not Answered Here?
IHS consults on both the Clinical and Non-Clinical Contact Center modules, and on multi-program URAC strategies for organizations pursuing Health Contact Center alongside other URAC accreditations. Contact us to discuss your organization's specific situation.