MPRO is accredited by URAC. Accreditation by URAC helps provide organizational structure, consistency and quality. A part of being URAC accredited is educating our staff about what accreditation means to us. Core is organizational wide and every MPRO employee should be familiar with the CORE module and the standards within this module.
Medicaid’s PACER, Audit and Medicare’s appeal team should also review the health utilization module (HUM) as this is applicable to your daily work.
Informal Dispute Resolution and those working with independent internal and external appeals should review the independent review module.
There are post tests to take upon completion. Please take these tests. Record the training on your log.
Health Utilization Management (HUM)
Independent Review Organization (IRO)