Quality Through Accreditation

Perhaps the most important aspect of any managed care solution is its accreditation by leading industry organizations dedicated to quality care and standardized medical services for all Americans.

Accreditation by the American Accreditation Health Care Commission (AAHCC/URAC) is an exhaustive and continuous process that requires managed care organizations to undergo a rigorous review of all products, services and internal operations. This self-examination strives to promote ethical, legal and superior operations performance at the hub of our managed care business.

CHN PPO has established and is committed to its Quality Management program, structured to assess the quality of care in the provider network. The program, designed from the standards established by AAHCC / URAC, provides the organization with an effective mechanism for assessment and response to potential or actual quality issues. CHN PPO is dedicated to the ongoing maintenance, support and expansion of the program.

All providers must submit to an extensive credentialing process before they can be accepted into the CHN provider network. To maintain the integrity of the network, providers are re-credentialed every two years utilizing established standards as approved by AAHCC / URAC including primary source verification:

Board certification Hospital privileges Medical school education and residency/fellowship training Malpractice insurance history Licensures/sanctions On-site inspections

As one of only a few accredited PPOs in the tri-state area, CHN PPO has the distinction of being one of the leading certified sources for managed care and PPO services. CHN PPO is re-accredited every two years and continues to maintain the standards and requirements set forth by the accreditation guidelines.