Turbocharge Your Provider Network Management

Turbocharge Your Provider Network Management Process

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 within the next 3 months, and they need to […]

Elevate Your Provider Network Management Process

Elevate Your Provider Network Management Process with Quest Enterprise Services® Volume Actions Package

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

The Hottest Dish in Provider Data Management Trends

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

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 […]

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 […]

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 […]

New Metrics are Critical to Addressing Mental Health Access Concerns

New Metrics are Critical to Addressing Mental Health Access Concerns

Our new normal is far from normal. There is this level of incredible, nonstop uncertainty around our current situation, and none of us are immune. CDC data, collected in late June, noted an increase month-over-month in mental health issues. It showed that 40 percent of adults struggled with anxiety, depression, suicidal thoughts and substance abuse1. […]

The Rebirth of Network Adequacy: Modernizing Health Plan Practice

Reprinted from The URAC Report. Nearly two months ago now CMS finalized changes to Medicare Advantage (MA) and Part D for 2021 and while I previously covered the new telehealth network adequacy provisions, I’ve been meaning to do a deeper dive into how network adequacy as a whole has changed in recent years. To do this, I reached out to Cari […]

Preparing for the Era of Provider Network Transparency

Copyright 2020 Compliance Today, a publication of the Health Care Compliance Association (HCCA). Transparency is one of the top buzzwords in healthcare today. In the last few years, we have seen the rollout of significant healthcare transparency initiatives focused on portable health records, hospital costs, drug costs, quality data, and many other things (e.g., Executive […]

Rule Raises Questions About Telehealth, Directory Accuracy

Reprinted with AIS Health permission from the July 2, 2020, issue of  RADAR on Medicare Advantage. As Medicare Advantage and other insurers report increasing use of telehealth during the COVID-19 pandemic and consider the larger role that virtual visits could play on a more permanent basis, CMS recently finalized a set of policies for 2021 […]