Conifer Health Solutions’ Value-Based Care line of business has again achieved certification in Utilization Management and Credentialing (UM/CR) from the National Committee for Quality Assurance (NCQA) for its Referral and Utilization Management services and solutions.

NCQA’s certification in the UM/CR program is available to a variety of organizations that perform Credentialing (CR) and/or Utilization Management (UM). The standards represent a merger of the POC (Physician Organization Certification) and OC (Organization Certification) products into a single set of standards designed for organizations that provide full scope CR or UM services or both. NCQA certification provides these organizations the opportunity to demonstrate the quality of their UM and CR programs.

NCQA is a private, non-profit organization dedicated to improving healthcare quality. NCQA accredits and certifies a wide range of healthcare organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS ®) is the most widely used performance measurement tool in healthcare. NCQA is committed to providing healthcare quality information for consumers, purchasers, healthcare providers and researchers.

“Achieving the Utilization Management/Credentialing certification from NCQA demonstrates that Conifer Health’s Value-Based Care service line has the systems, processes and personnel in place to conduct utilization management and credentialing in accordance with the strictest quality standards,” said Margaret E. O’Kane, president of NCQA.

According to Diane Penn, chief compliance officer for Value-Based Care at Conifer Health, key factors in certifying these services were the success of client results and the company’s commitment to delivering high-quality service. “This is an important recognition of the dedication and the work we do for the clients we serve,” said Penn. “Earning NCQA certification underscores Conifer Health’s expertise in helping healthcare organizations make the transition to value-based care.”

About NCQA

NCQA is a private, non-profit organization dedicated to improving healthcare quality. NCQA accredits and certifies a wide range of healthcare organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing healthcare quality information for consumers, purchasers, healthcare providers and researchers.

About Conifer Health Solutions

Conifer Health Solutions is a healthcare services company working to improve operational performance for more than 700 clients. The company’s expertise supports financial improvement, enhances the patient experience, and drives value-based performance. Through our revenue cycle management, patient communication and engagement, and value-based care solutions, we empower healthcare decision makers – hospitals, health systems, physicians, self-insured employers, and community and government health plans – to better connect at every point of patient engagement. We have more than 17.5 million patient interactions annually across all of our service lines. Conifer Health manages $25 billion in annual patient revenue, and provides technology and health management services to support care management for more than 4 million lives. For more information, call 1-877-CONIFER, visit www.coniferhealth.com or follow @coniferhealth on Twitter.

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