WHAT IS DELAYED ACCREDITATION?

After the review of a laboratory's accreditation application, the Board of Directors renders an accreditation decision. One of four decisions will be made: granted, delayed, site-visit, or denied. A delayed decision means that there are significant issues, deficiencies or lack of adherence to the ICAVL Standards that must be addressed by the laboratory before it can be granted ICAVL accreditation.

WHAT DELAY MEANS TO THE LAB SEEKING REACCREDITATION

All accredited laboratories receive a notification letter twelve to fourteen months prior to the expiration of their accreditation. Board meetings are generally scheduled within two weeks of the expiration dates on the laboratory's current accreditation certificates. It is crucial that laboratories apply by the deadline specified in this letter and submit a complete application without significant deficiencies.

The laboratory will be notified in writing of the Board's accreditation decisions within two to three weeks after the Board meeting. This letter will outline the reasons for the delayed decision and include the documentation that must be submitted in order to correct the lack of adherence to the ICAVL Standards. To better accommodate laboratories in the reaccreditation stage, the Board of Directors instituted a 60-day provisional accreditation. The provisional period gives a laboratory that has been delayed reaccreditation 60 days to resolve delay issues and provide the required or corrected documentation to the ICAVL, upon which the final decision will be made by the Board of Directors. During the 60 days, the laboratory will be granted a continued presence on the ICAVL website as an accredited laboratory and continued use of the ICAVL Accredited Laboratory logo. The 60-day provisional timeframe is intended to minimize the inconvenience of needing to redesign reports and letterhead acknowledging their accreditation status and concerns about meeting reimbursement guidelines. However, laboratories are still required to submit their reaccreditation applications for the recommended application deadlines.

Laboratories that do not correct delay issues during the 60-day provisional period will no longer be considered accredited. Those laboratories are automatically deleted from the list posted on the ICAVL website once their provisional period has expired. Because Medicare, third party payers, referring physicians and patients refer to this list, a lapse in status can affect billing or community relations. In addition, the ICAVL logo affirming the laboratory's status as an "Accredited Vascular Laboratory" must be removed from any materials, along with any other references to accreditation by the ICAVL, by any laboratory that does not maintain its accreditation.

STEPS YOU CAN TAKE TO AVOID DELAY

• Review the Application Review Findings (ARF) letter sent to your laboratory when accreditation was last achieved.
  
  
• Verify that your laboratory is adhering to the current edition of the ICAVL Standards. Dates of revision are listed in the footer of every page. Verify that the date on your materials corresponds to those on the web, or contact our office to make sure you are using the correct edition.
  
  
• Be certain that all case studies document your laboratory's adherence to The Standards. For example, approximately 50% of venous applications are delayed because laboratories fail to document Doppler insonation of the contralateral common femoral vein in unilateral cases and/or because they have not revised protocols to reflect its documentation.

COMMON REASONS FOR DELAY

• The most common reasons for delay in Extracranial Cerebrovascular, Peripheral Arterial and Visceral Vascular testing are insufficient documentation of complete examinations. The Standards clearly outline the minimum number of images and Doppler samples required for each vascular examination.
  
  
• A number of laboratories are also delayed for insufficient numbers of quality assurance correlation. The Standards specify minimum numbers of correlations required for reaccreditation in each area of testing. For example, laboratories are required to submit a minimum of 30 internal carotid artery correlations with radiographic and/or surgical results over the past three years.
  
  
• Insufficient CME credits are submitted for the medical or technical staff members. You can review the ICAVL requirements for continuing medical education credits here.