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American Specialty Health is First Complementary Health Care Organization to Earn NCQA ``Organizational Certification'' in Credentialing and Utilization Management.


SAN DIEGO San Diego (săn dēā`gō), city (1990 pop. 1,110,549), seat of San Diego co., S Calif., on San Diego Bay; inc. 1850. San Diego includes the unincorporated communities of La Jolla and Spring Valley. Coronado is across the bay.  -- American Specialty Health (ASH), the nation's leading complementary health care benefits organization, and the National Committee for Quality Assurance National Committee for Quality Assurance Medical practice A private, not-for-profit organization which has become the leading accreditor of managed care plans; in site visits, NCQA reviewers evaluate a managed care plan in terms of quality management, physicians'  (NCQA NCQA National Committee on Quality Assurance, see there ) recently announced that ASH is the first specialty health organization for complementary health care to earn certification for both credentialing and utilization management Utilization management is the evaluation of the appropriateness, medical need and efficiency of health care services procedures and facilities according to established criteria or guidelines and under the provisions of an applicable health benefits plan. .

The certification applies to two ASH subsidiaries, American Specialty Health Plans of California, Inc. (ASH Plans) and American Specialty Health Networks, Inc. (ASH Networks).

Each NCQA-certified organization is subject to a desktop audit, telephone interviews, and an onsite survey. Currently, health plans and employer groups employer group Association of employers Managed care An entity with a current group benefits agreement in effect with a health plan to provide covered health care services to its employee-subscribers and eligible dependents.  may delegate responsibility for credentialing and utilization management to another organization -- such as ASH -- that specializes in those areas. As a result of this certification, NCQA-accredited organizations can streamline delegation activities when contracting with ASH. The benefit of contracting with an NCQA-certified organization is explained in its Nov. 2004 Organizational Certification policy memo A policy memo is a brief (2-3 pages) memo targeted to a specific audience, usually policy makers, advocating a policy with just sufficient analysis of alternatives regarding a current policy debate. . This certification affords industry-standard quality while making delegation more cost-efficient for ASH and its clients.

"We are extremely proud to have earned certification from NCQA in credentialing and utilization management," said George DeVries, chairman, president, and chief executive officer of ASH. "Achieving certification in both areas shows once again that ASH is committed to providing quality services to our contracted health plans and employer groups."

NCQA is an independent, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans, managed behavioral healthcare organizations, preferred provider organizations preĀ·ferred provider organization
n.
Abbr. PPO A medical insurance plan in which members receive more coverage if they choose health care providers approved by or affiliated with the plan.
, new health plans, physician organizations, credentials verification organizations, disease management programs, and other health-related programs. Consumers can easily access health plans' NCQA Accreditation statuses and other information on health care quality on NCQA's Web site at www.healthchoices.org, or by calling NCQA Customer Support at (888) 275-7585.

ASH and its subsidiaries are the nation's leading specialty benefits organization for complementary health care -- providing benefit, health education, wellness, and affinity discount programs to health plans, insurance carriers, employer groups, and trust funds nationwide. Its subsidiary, ASH Plans, which operates in California, is the nation's first and largest specialty health plan for chiropractic chiropractic (kīrəprăk`tĭk) [Gr.,=doing by hand], medical practice based on the theory that all disease results from a disruption of the functions of the nerves.  and acupuncture acupuncture (ăk`ypŭng'chər), technique of traditional Chinese medicine, in which a number of very fine metal needles are inserted into the skin at specially designated points. , providing benefit programs to full-service health plans and employer groups. ASH Networks is a third-party administrator for complementary health care benefits for self-funded employers, insurance carriers, and health plans in more than 30 states. It provides ASH's administrative services and contracts with providers for ASH's national network of chiropractors, acupuncturists, and other providers. Based in San Diego, ASH has more than 500 employees and more than 12 million members in benefit programs nationwide. For more information about ASH, visit ASHCompanies.com or call (800) 848-3555.
COPYRIGHT 2005 Business Wire
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Copyright 2005, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Publication:Business Wire
Date:Nov 22, 2005
Words:422
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