Healthcare Networks

Healthcare Networks

As a “seal of approval” from industry peers recognizing excellence in health data processing and transactions, the Healthcare Networks Accreditation Programs (HNAP)  are ideal for organizations that manage and exchange protected health information (PHI).

These accreditation programs indicate that you exceed industry-established standards and comply with HIPAA regulations in areas such as privacy and confidentiality measures, level-of-service and escalation procedures, transaction response times, and systems availability. They assess security infrastructure and data integrity measures including disaster recovery; business continuity; contingency plans; and intrusion detection and response. The programs also evaluate transaction processing efficiency; ability to comply with generally accepted, industry-standard data formats; and audit trail capabilities.

Our Programs:

  • reduce risk to PHI and operations through the demonstration of a risk management program with effective controls that appropriately minimize threats.
  • prepare your organization for third-party audits including 21st Century Cures Act; HIPAA/HITECH compliance audits that are now being conducted for the Office of Civil Rights (OCR); trading partner audits (some payers require DirectTrust accreditation as a condition of processing their transactions); and state compliance (DirectTrust accreditation is accepted by Maryland and New Jersey to meet the requirement for processing healthcare transactions in those states).
  • enhance trust for your customers, trading partners, and other stakeholders.

To further accommodate an expanding field, we offer several additional subcategories of this accreditation with criteria more specific to the realities of a range of market niches.

Healthcare Networks Accreditation Program for Electronic Health Networks, our primary accreditation program, is intended for companies or organizations whose electronic health networks perform claims clearinghouse or EDI gateway functions.

Healthcare Networks Accreditation Program for Third-Party Administrators, the first program of its kind, accredits third-party administrators or other companies that manage health plans and benefits on behalf of employers and other self-insured entities.

Healthcare Networks Accreditation Program for Payers is for payer-owned electronic health networks and expands on the core accreditation criteria to assure all clearinghouse functions and organizational standards are world-class. Payer-specific and expanded criteria regarding security against intrusion and protection of confidential PHI are also included.

Healthcare Networks Accreditation Program for Medical Billers accredits companies that handle sensitive data as part of their coding, billing, and other services on behalf of provider organizations including physician practices and hospitals, as well as health systems, labs and other types of healthcare organizations.

To begin the application process for any of our programs, please complete the application form through our website. Program criteria are located on the criteria page.

Also, are you looking for hands-on support to help you through the pre-assessment steps, readiness planning process and more? Learn about our Consulting and Advisory Services which have been designed to provide additional guidance in completing these accreditation programs.

Ready to move forward?

Apply for Accreditation

Accredited Organizations