The standards, provide a framework for implementing best practices to improve:

• Quality Management and Improvement: Monitors, evaluates and improves the quality and safety of care.
• Care Coordination: Coordinates medical care and behavioral healthcare for its members.
• Utilization Management: Notifies members and practitioners about coverage decisions within required time frames.
• Credentialing and Recredentialing: Verifies the credentials of the practitioners in its network.
• Members’ Rights and Responsibilities: Has a written members’ rights and responsibilities policy.