Network Performance Services

Provider Claims Activity

Optimize your networks for peak performance

View clinical activity of providers classified as peripheral, core, standard, and ghost.

Gain a Holistic View of Your Provider Information

Provider Claims Activity (PCA) provides you with the comprehensive insights you need to evaluate your network based on active provider activity across lines of business – helping you optimize your network to recruit viable providers fasters, increasing your speed to market, reducing regulatory risk and increasing your member satisfaction.

Provider Claims Activity (PCA) includes:
  • Total Claims Volume by NPI (All LOBs)

Provider Claims Activity (PCA)*

Start optimizing your network by viewing the activity of providers, classified as:

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Ghost (No patients)

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Peripheral (0-24th percentile)

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Standard (25th – 74th percentile)

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Core (75th percentile and above)

You can view these indicators in total and by lines of business within our Quest Enterprise Services platform, including commercial, Medicaid and Medicare allowing you to recruit viable providers with confidence and in less time.

*Requires Quest Enterprise Services

Creating a Power Combination of Insights – PCA + QES

Our Quest Enterprise Services platform is the only provider network management solution that brings adequacy and accuracy together in one platform – making it easy to see what’s right, wrong or missing from your provider data and linking those actionable insights into your network’s adequacy, highlighting variances and identifying gaps.

Expert Consultants

Our consultants have deep professional services industry experience and data analytics proficiency. They are ready to help you achieve your network performance goals.

Optimize Your Network Today

Our team is ready to help you discover how Provider Claims Data can bring a new approach to your network builds — helping you get to market faster while improving member satisfaction.

Schedule a consultative session with one of our performance analytics experts to discuss and determine your strategy.

Book a Strategy Session