As a national specialty health benefit management and integrative medicine network, WholeHealth Networks, Inc., a subsidiary of Tivity Health, Inc.TM, is committed to maintaining a comprehensive UM program through effective practitioner recruitment and selection, consistent high-standard credentialing, and by complying with regulatory, accreditation and certification requirements. WholeHealth Networks, Inc. has been accredited with URAC for Health Utilization Management (HUM) since 1997 and accredited with NCQA for Utilization Management (UM) since 2014.
WholeHealth Networks, Inc. Credentialing Department, a Credentialing Verification Organization (CVO), provides primary source verification services, and has been awarded CVO certification by NCQA.
Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification, education, and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Their portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to show-case their validated commitment to quality and accountability.
NCQA is an independent, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans, managed behavioral healthcare organizations, preferred provider organizations, new health plans, physician organizations, credentials verification organizations, disease management programs and other health-related programs. NCQA’s mission is to improve the quality of health care.