The IPRO Quality Management System (QMS) has been assessed and certified by DNV as meeting the requirements of the International Organization for Standardization (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 8, 2024, follows six previous certifications.
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.
IPRO was one of the first organizations to be accredited by URAC to conduct external, independent reviews of managed care coverage disputes. A leading healthcare 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 Healthcare Effectiveness Data and Information Set (HEDIS®) Compliance Audits™, IPRO employs a staff of NCQA-certified HEDIS® auditors with expertise in the calculation and validation of HEDIS® measures.
IPRO has
completed a SOC 2 Type 2 audit and received an “unqualified opinion” indicating
that the organization meets standards for the American Institute of Certified
Public Accountants’ “trust service principle” concerning security.
IPRO is a member of The National Association of Health Data Organizations (NAHDO), a not-for-profit national membership organization dedicated to improving healthcare through the collection, analysis, dissemination, public availability, and use of health data.
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).
IPRO is a member of Health Level Seven International (HL7) is a not-for-profit, ANSI-accredited standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services.
Across nearly 100 state and federal programs in 32 states, IPRO makes creative use of clinical expertise, emerging technology, and data solutions to make the healthcare system work better.
HEADQUARTERS:
1979 Marcus Avenue
Lake Success, NY 11042-1072
Phone: 516-326-7767
Toll Free: 800-852-3685
Fax: 516-328-2310
TTY: 800-662-1220 or 711
