Accreditations & Awards
CERTIFICATION
The National Committee for Quality Assurance is a private, not-for-profit organization dedicated to improving health care quality. Their mission is to improve health care quality through measurement, transparency and accountability.
Program Scope, Date First Certified, Dates of Current Cycle
ASH Networks and ASH Plans were the first complementary health care companies to receive NCQA Organization Certification in Utilization Management and Credentialing. This Certification process focuses on consumer protection and improvement in service to customers. Standards recognize that organizations that apply for certification have open-access networks, and can improve service quality and utilize customized structures to meet purchaser needs. First certified: October 2005. Current cycle: October 2007-2009.
ASH has not pursued NCQA accreditation as NCQA does not accredit specialty health plans. It should be noted that ASH programs are currently delegated to by more than 50 NCQA-accredited health plans for many of the services offered by ASH, including utilization management, provider quality management, claims processing, provider credentialing, and member services. ASH continues to align its operations to comply with NCQA standards to support good business practices and NCQA accredited customers.
ACCREDITATION
URAC is nationally recognized as the leading entity for accrediting specialty health plans. By applying for and receiving URAC accreditation, American Specialty Health Insurance Company (ASH Insurance Company), American Specialty Health Networks, Inc. (ASH Networks), American Specialty Health Plans of California, Inc. (ASH Plans), American Specialty Health IPA of New York, Inc. (ASH IPA), American Specialty Health ODS of New Jersey, Inc. (ASH ODS), American Specialty Health Networks of South Dakota, Inc. (ASH Networks SD), and Healthyroads, Inc, have demonstrated the commitment to be measured by nationally accepted health care benchmarks. This accreditation assures health plans, employer groups, members, and providers that ASH maintains the infrastructure and processes necessary to promote high-quality health care.
The URAC health program accreditations received by ASH include a comprehensive review of organizational structure, administrative services, network management, quality management, utilization management, provider services, provider credentialing, member participation and protection, and claims processing. Although URAC also offers a certification process available to organizations that opt for a less comprehensive evaluation, ASH has opted to pursue full accreditation rather than the certification process.
Program Scope, Date First Accredited, Dates of Current Cycle
- Health Plan (including chiropractic, acupuncture, massage therapy, naturopathy, and dietetic counseling programs) - These standards include key quality benchmarks for network management, provider credentialing, utilization management, quality management and improvement and consumer protection. The standards are appropriate for HMOs and other integrated health plans. First accredited: 11/98. Current cycle: 11/07-11/09.
- Health Network with Credentialing (including chiropractic, acupuncture, massage therapy, naturopathy, and dietetic counseling programs) - Health Network Accreditation is similar to Health Plan, but does not include UM, and is generally more applicable to PPOs. First accredited: 11/98. Current cycle: 11/07-11/09.
- Health Utilization Management (including chiropractic, acupuncture, massage therapy, naturopathy, and dietetic counseling programs) – These standards ensure that organizations conducting utilization review follow a process that is clinically sound and respect patients’ and providers’ rights while giving payors reasonable guidelines to follow. First accredited: 11/98. Current cycle: 11/07-11/09.
- Claims Processing Organization (including chiropractic, acupuncture, massage therapy, naturopathy, and dietetic counseling programs) - This program is designed to validate that standards are met in areas such as accuracy, timeliness, notification to claimants, and quality monitoring. First accredited: 2/03. Current cycle: 2/08-2/10.
- HIPAA Privacy - ASH affiliates holds URAC’s HIPAA Privacy accreditation and HIPAA Security accreditation. These programs outline a framework of best practices that describe the operational policies and procedures necessary for an effective HIPAA compliance program. ASH received accreditation as both a covered entity and a business associate. First accredited: 7/03. Current cycle: 7/07-7/09.
- HIPAA Security - ASH affiliates holds URAC’s HIPAA Privacy accreditation and HIPAA Security accreditation. These programs outline a framework of best practices that describe the operational policies and procedures necessary for an effective HIPAA compliance program. ASH received accreditation as both a covered entity and a business associate. First accredited: 12/03. Current cycle: 12/07-12/09.
- Health Website: www.HealthyRoads.com . These standards promote creditability, trust, and quality of online health information and privacy practices of Web sites. First accredited: 2002. Current cycle: reaccreditation under review
ASH staff receives training on NCQA and URAC requirements upon hire and annually thereafter. As new requirements are developed and/or revised, they are presented to ASH’s Corporate Compliance Committee (CCC). The CCC reviews the standards and determines the current level of compliance. If changes are required to support the new requirement, the CCC delegates action items to the applicable key process teams to implement the change and ensure compliance with these standards. Action items are maintained on a master action log and monitored by CCC until completed.
Accredited health plan clients perform regular delegation audits and no audit has resulted in de-delegation for failure to perform or comply with URAC or NCQA. To achieve and maintain successful delegation audit results, ASH’s operations consistently support all applicable accreditation organization standards.
ASH is committed to maintaining URAC accreditation and NCQA Organization Certification in Utilization Management and Credentialing. More information is available at the URAC Web site (www.urac.org) and at the NCQA Web site (www.ncqa.org).
2008
Named among the 100 “Best Places to Work in Healthcare” by Modern Healthcare magazine
National Business Group on Health Awards American Specialty Health a Gold “Best Employers for a Healthy Lifestyle” Award
Named One of America’s 15 Fittest Companies by Men’s Fitness magazine
Health Care Communicators of San Diego Finest Awards
- “Best in Show,” eXtremeQUIT® teen tobacco cessation materials
- Gold Award, Brochures—Series (3 or more color): eXtremeQUIT teen tobacco cessation materials
- Gold Award, Brochures—Single (3 or more colors): 2006 Year in Review brochure
- Gold Award, Special Events, Internal: Multiple-Day Event: “I Stepped it Up with George & Bob” Walking Challenge
- Silver Award, Special Events, Internal: Single-Day Event: 2007 “Sea of Stars” Corporate Awards Banquet
- Silver Award, Brochures—Single (3 or more colors): Health Plan Sales Brochure
- Silver Award, Brochures—Series (3 or more colors): eXtremeFUN™ Parent Supplemental Guides
- Bronze Award, Public Relations Campaigns, Internal: ASH Internal Wellness Campaign
- Bronze Award, Audio/Visual External Video Program: FitnessCoach® health improvement online Flash classes
2007
Health Care Communicators of San Diego Finest Awards
- Gold Award, Brochures— Single (3 or more colors): 2005 Year in Review
- Gold Award, Brochures—Series (3 or more colors): Healthyroads eXtremeFUN Weight Management for Kids and Teens
- Gold Award, Special Events, External: Multiple-Day Event: ASH Bridges to Better Health Conference
- Silver Award, Brochures—Single (3 or more colors): Health Plan Sales Brochure
Awards for Publication Excellence (APEX)
- Grand Award, Electronic & Video Publications (For Profit): Silver&Fit® Healthy Aging DVD
- Award of Excellence, Web & Intranet Sites:
www.QuitAndFit.com tobacco cessation Web site
- Award of Excellence, Health, Fitness, & Medical Materials: eXtremeFUN childhood obesity educational materials
- Award of Excellence, Meeting & Event Campaigns & Programs: Bridges to Better Health Conference
San Diego Business Journal Names ASH CEO George DeVries a “Health Care Champion” Finalist
ASH Recognized as Finalist in URAC’s Best Practices in Consumer Empowerment and Protection Awards
2006
San Diego Business Journal Names ASH One of the “Best Places to Work in San Diego”
San Diego Magazine Lists ASH Among the 10 Best Places Workplaces in San Diego
National Initiative for Children’s Healthcare Quality (NICHQ) Names Healthyroads‚ eXtremeFUN Weight Management Program for Children and Teens One of the Nation’s Best
eHealthcare Leadership Awards
- Silver Award, Best Site Design: Healthyroads.com
- Award of Distinction, Best Overall Internet Site: Healthyroads.com
2005
Health Care Communicators of San Diego Finest Awards
- Gold Award, Brochures—Single (3 or more colors): 2003 Year in Review brochure
- Gold Award, Advertising—Direct Mail/Direct Response: Broker Road Show Invitation
- Gold Award, Internal Communications: ASH Internal Communications Plan
- Gold Award, Off-the-Wall: “Walk the Talk” Challenge
- Gold Award, Web Site Redesign: ASHcompanies.com.
- Gold Award, Interactive CD-ROMS: Healthyroads for Living Premium Tobacco Cessation Module
- Silver Award, Special Publications: Healthyroads for Living Cookbook
- Silver Award, Web Site Redesign:
www.HealthyRoads.com
- Silver Award, E-zines/Internet Newsletters: ASH News Flash
- ASH CEO George DeVries Receives 2005 “BC Superstars” Award from Benefits & Compensation Solutions Magazine
ASH CEO George DeVries Receives 2005 “BC Superstars” Award from Benefits & Compensation Solutions Magazine
2004
America’s Health Insurance Plans (AHIP)
- George DeVries, chairman, president, and CEO of American Specialty Health was presented with the 2004 Innovators Award by America’s Health Insurance Plans (AHIP)
Astrid Awards
- Bronze Award, for “Walk the Talk” pedometer contest
National Healthcare Advertising Awards
- Gold Award, poster: “Walk the Talk” pedometer contest
- Merit Award, brochure: 2002 Year in Review
- Merit Award, calendar: Holiday card calendar
- Merit Award, other: ASH Trade Show Exhibit
- Merit Award, Web site: ASH News Flash
Communicators Awards
- 2004 Award of Distinction, for article published in Employee Benefits Journal, authored by ASH CEO George DeVries
2003
Healthyroads.com
- World Wide Web Health Awards (Best E-Commerce Site, 4 Gold Awards in categories of Health Promotion, Disease Prevention, Patient Education, and Private Business)
ASHCompanies.com
- World Wide Web Health Awards (6 Bronze Awards in categories of Advertising and Marketing for HMO/Managed Care Systems, Insurance Company, and Private Business)
Health Care Communicators of San Diego Finest Awards
- Gold Award, Special Publications: Healthyroads Premium Weight Management Module
- Gold Award, Interactive Communications: ASH News Flash
- Gold Award, Publications/Collateral Design: Health Net of Oregon Brochure
- Silver Award, Exhibits: American Specialty Health Exhibit
- Silver Award, Direct Mail: Provider Recruitment Brochures
National Health Information Awards
- Bronze Award, Patient Education Information/Audio: Healthyroads Module
- Bronze Award, Patient Education Information/Books: Healthyroads Guidebook
- Merit Award, Complementary Health Care Education: ASH Educational Brochures
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