Quest Analytics Launches Provider Claims Insights Integrated into Quest Enterprise Services
Quest Analytics, the leader in provider network management solutions and services, today announced the launch of Provider Claims Insights. This new offering adds provider performance measures within the Quest Enterprise ServicesTM (QESTM) platform to help health plans improve provider selection and overall network performance. Quest Enterprise Services Provider Claims Insights gives network teams the tools […]
Turbocharge Your Provider Network Management
Imagine this: You’re responsible for managing a network of healthcare providers, and one day you check your inbox – there it is – an urgent email from top executives at your company asking for your help. They’re considering ending the agreements with a few providers by June 30th of this year and they need to […]
Elevate Your Provider Network Management Process
Quest Enterprise Services Volume Actions Package: Turn it Up to 11! Volume is always a good thing! We like the volume of our music at least an 11. We love the volume of our hair to be thick and full. And we absolutely love the volume of time that we save with the Quest Enterprise […]
Top Trends For Provider Data Management
Summer is here, and we don’t want you to spend it working long hours behind your computer. That’s exactly why we’re sharing the latest Provider Data Management trends that will help you knock out your To-Do list, enhance teamwork, and streamline your provider data management process. With more time on your hands, you’ll be free […]
Quest Analytics Introduces Network Performance Services
OVERLAND PARK, KS (November 15, 2022) – Quest Analytics, the leader in provider network management solutions and services, today introduced Network Performance Services, a new offering that helps optimize provider networks with in-depth performance analytics, competitive network benchmarking and provider claims activity. Through automated tools and available expert consultants, Network Performance Services provides clients with critical […]
Policy Trends Across Health Insurance Markets
EVOLVING HEALTHCARE POLICY LANDSCAPE FOR NETWORK ADEQUACY Regulators and policymakers continue to make changes that strengthen federal and state oversight processes for Medicare Advantage, Marketplace, and Medicaid Health Plans. Let’s look at what’s happening in each market. Medicare Advantage: Network Adequacy Requirements for Applications In a previous blog post, we discussed how the Centers for Medicare […]
Federal Medicaid Network Adequacy Standards
BASIC MCO QUANTITATIVE NETWORK ADEQUACY STANDARDS OVERVIEW This Basic Overview is an overview of what is required of States under current federal regulations.3 At a minimum, a State must develop a quantitative network adequacy standard for the following provider types, if covered under the MCO contract: Primary care, adult and pediatric OB/GYN Behavioral health (mental health and […]
Consideration for Health Equity Measures in Network Adequacy Standards
The Affordable Care Act (ACA) directed the Centers for Medicare & Medicaid Services (CMS) to establish rules to require that Exchange health plans ensure a sufficient choice of providers.1 To implement this requirement, CMS adopted quantitative standards, which require Exchange health plans to ensure that its network providers are available to members within specified time and […]
Improving Network Adequacy and Access For Mental Health
Federal and state policymakers are taking a variety of measures to improve access to mental health services and substance use disorder treatments. Network adequacy and access are prominent areas of such a response directly affecting health plans. This blog post informs stakeholders about the increased emphasis on behavioral health networks and tips on how to […]
Key Application Dates: Unpacking The CMS Medicare Advantage Calendar
Centers of Medicare & Medicaid Services (CMS) Key Application Dates for CY 2022 Medicare Parts C and D Annual Calendar Our CMS calendar is one of the easiest ways to stay up-to-date with important dates and timelines for CY 2022 Medicare Advantage (MA) plans, Medicare Advantage-Prescription Drug (MA-PD) plans, Prescription Drug Plans (PDPs), Medicare-Medicaid Plans […]
