UM Information Integrity oversight requirements related to UM request receipt and UM decision notification dates may be scored Not Applicable (NA) for delegates that only perform approvals and/or recommendations. Please note that this exception does not apply to delegates that make denial decisions.
Factors 5–7 are limited to the evaluation of UM receipt and notification dates.
Applicable standards:
- Health Plan Accreditation: UM 12, Element C, factors 5–7
- Utilization Management Accreditation: UM 8, Element C, factors 5–7
- Behavioral Health Accreditation: UM 10, Element C, factors 5–7
