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Frequently Asked Questions Insurance

The Carrier Letter lists "accreditation of Plan Management including oversight of delegated responsibilities, subcontractor functions and customer service” as one requirement for modular accreditation. Would a modular accreditation that includes CORE standards in the review (e.g. URAC Case Management) meet this requirement?

No. Modular accreditation of a specific function only examines how the core standards apply to that function and does not evaluate plan "oversight of all delegated responsibilities, subcontractor functions, and customer service."

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