The IPRO Quality Management System (QMS) has been assessed and certified by SGS International Certifications Services (SGS ICS) as meeting the requirements of ISO 9001:2015 for the provision of healthcare services. These services include the design, development and implementation of Medicare and Medicaid quality improvement and assessment activities; utilization review; external appeals; data collection, analysis and validation; special studies; and consulting for Federal, State and local government agencies, managed care organizations and private sector clients. The three year certification, which is valid through November 2021 follows five previous certifications by SGS.
ISO is an international quality management standard and framework for business-to-business dealings, focusing on meeting customer quality and applicable regulatory requirements, enhancing customer satisfaction and continually improving business performance from the initial proposal/contracting stage through the delivery of service.
ISO certification guarantees IPRO’s customers that a quality management system is in place, facilitating better systems processes and management of the company. The framework helps identify system gaps, requires risk based thinking, provides a strong foundation for continuous improvement and assists in organizational compliance with other accreditation programs.
IPRO was one of the first organizations to be accredited by URAC to conduct external, independent reviews of managed care coverage disputes. A leading health care accreditation organization, URAC developed rigorous standards in 2001 designed to ensure that the independent review process is fair, objective and timely.
URAC standards assure that organizations that perform this service are free from conflicts of interest, establish qualifications for physician reviewers, address medical necessity and experimental treatment issues, have reasonable time periods for standard and expedited reviews, and appeals processes.
An organization with this URAC accreditation strives for a fair and impartial review process that is of benefit to both patients and physicians with grievances.
Certified by the National Committee for Quality Assurance (NCQA) to conduct HEDIS® Compliance Audits™, IPRO employs a staff of NCQA-certified HEDIS® auditors with expertise in the calculation and validation of HEDIS® measures.
National Quality Forum
IPRO is an active member of the National Quality Forum (NQF), a not-for-profit membership organization created to develop and implement a national strategy for health care quality measurement and reporting.
IPRO is a member of The National Association of Health Data Organizations (NAHDO), a not-for-profit national membership organization dedicated to improving health care through the collection, analysis, dissemination, public availability, and use of health data.
The eHealth Initiative and the Foundation for eHealth Initiative are independent, non-profit affiliated organizations whose missions are the same: to drive improvement in the quality, safety, and efficiency of health care through information and information technology.
Both organizations are focused on engaging multiple and diverse stakeholders–including hospitals and other healthcare organizations, clinician groups, consumer and patient groups, employers and purchasers, health plans, health care information technology organizations, manufacturers, public health agencies, academic and research institutions, and public sector stakeholders–to define and then implement specific actions that will address the quality, safety and efficiency challenges of our health care system through the use of interoperable information technology.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
HEDIS® Compliance Audit™ is a trademark of the National Committee for Quality Assurance (NCQA).