understanding the compliance demands of state requirements and guidelines.
We understand the compliance demands of state requirements and guidelines. That is why our review strategy includes a comprehensive analysis of federal and state regulations and national guidelines.
URAC
ezURs is a URAC accredited Comprehensive Independent Review Organization. URAC’s Independent Review Organization (IRO) helps ensure that organizations that perform IRO services are free from conflicts of interest, establish qualifications for physician reviewers, address medical necessity and experimental treatment issues, and have reasonable time periods for standard and expedited reviews and appeals processes. URAC offers IRO accreditation for organizations conducting internal review (on behalf of the health benefits plan), external review (often mandated by state law), or both.
HIPAA
ezURs maintains compliance with all State and Federal laws pertaining to the disclosure of individually-identifiable health information (IIHI). It is recognized that in some cases, State laws have more stringent requirements. IIHI is known as Protected Health Information (PHI) under HIPAA. While part of our operations (Workers’ Compensation) is exempt from the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191) [HIPAA], reviews done for other clinical areas are subject to this law. Except for workers’ comp cases, the corporation will send out the ‘Notice of Privacy Practices’ to patients, clients, and providers as required by law.
Security
Security and integrity of data is of the utmost importance at ezURs. From our employee practices and electronic systems, data centers, operations centers and disaster management fail-safe measures, client information is rigorously protected. Our security and compliance practices are consistently reviewed and updated per URAC standards, with every effort made to create a no-risk structure and strategy to ensure that our clients’ data and work processes are protected against even the most extreme scenarios. Monitoring is a critical aspect of internal control. Management and supervisory personnel are responsible for monitoring the quality of internal control performance as a routine part of their activities.