How does URAC evaluate the complaint resolution process?

URAC evaluates the complaint resolution process by analyzing how complaints are handled and resolved to member satisfaction. This method focuses on the overall effectiveness of the resolution process, ensuring that not only are complaints addressed, but that members feel their issues have been taken seriously and resolved satisfactorily. Member satisfaction is a key performance indicator, as it reflects the organization's commitment to quality service and continuous improvement.

In this context, while random audits, average response times, and member surveys provide important insights into various aspects of complaints, they do not directly capture the essence of satisfaction with the resolution itself. Analyzing the handling and resolution process allows URAC to assess whether members feel their complaints were important and whether the responses met or exceeded their expectations, which is critical for maintaining trust and engagement with the organization.