Accreditation is one of the most important things that healthcares plan or a service provider can have. Without the stamp and seal of accredited institutions, applying for and obtaining healthcare coverage payouts can be an extremely difficult procedure. Currently, there are several bodies in the United States which oversee the process of accreditation for healthcare policy providers. Two of these include the National Committee for Quality Assurance (NCQA) and the Joint Commission on Accreditation of Health Care Organizations (JCAHO). These organizations are responsible for holding health plan providers to certain standards of care in order to be officially accredited. While many businesses can operate without accreditation, it is always preferable to give your business to a provider that has proven its ability to comply with national standards.

There are two ways that the process of accreditation can affect your healthcare coverage and benefits. First, if your provider has not been approved by the NCQA, JCAHO or other federally-approved accreditation plan, their ability to manage your care is suspect. If your plan is not accredited, it is worthwhile to call them and ask why. Was it that they failed the process, or did not choose to apply? Either way, their lack of accreditation may be an indication that they do not take patient care seriously or that they will be unable to provide a timely response to claims, or any payout for health claims at all.

Secondly, it is important that any treatment you seek comes from accredited institutions. Hospitals and clinics, just like insurance companies, are subject to this process. JCHAO is responsible for accrediting health providers, as well as hospitals and clinics, and organizations like CARF are responsible for doing the same for rehabilitation providers. If your care is not received from an accredited institution, two outcomes could result. First, the level of care given may not match up to the national standard, and could in fact do more harm than good, and second, your insurance policy may not cover the cost of treatments that are not preformed by an accredited institution.

What accreditation means for insurance consumers are higher levels of reliability and a dedication to meeting national standards. While not every business, hospital, or clinic that is accredited will have stellar care and excellent response times, it is far more likely that they will have better customer service and quality of care than their non-accredited counterparts. In order to make sure that the healthcare insurance you pay for each month is doing the most it can, make sure that it comes from an accredited provider, and that you attend an accredited institution should you need anything from basic care to complex treatments.