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 […]
Quest Analytics to Showcase Provider Data Integrity Solutions at AHIP 2023
Quest Analytics, the leader in provider network management solutions and services, will attend AHIP 2023 this week and showcase its Quest Enterprise Services® (QES®) Accuracy Solution. Quest Analytics’ Accuracy Services is the industry’s leading solution for provider data accuracy, uniquely linking regulatory compliance with a health plan’s member experience, network integrity and network performance within […]
Creating an Effective Provider Data Management Strategy
It is Friday afternoon, and all you can think about is getting out on the green tomorrow at the top-notch golf course everyone talks about. The only problem is scoring a coveted Saturday tee time takes serious planning skills. If you have not booked it already, forget about it. You might as well plan to […]
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 […]
Provider Data Management Tips to Successfully Meet the No Surprises Act
We know the No Surprises Act can be a bit confusing, but no worries, we’re here to help. In this blog post, we’ll be sharing some insider insights and provider data management tips for health plans like yours on how to meet the provider directory requirements of the No Surprises Act. Let’s dive in and […]
Four Pillars to Guide the Success of the National Directory of Healthcare Providers and Services
Consideration for Establishing a National Directory of Healthcare Providers and Services On October 5, 2022, the Centers for Medicare & Medicaid Services (CMS) released a Request for Information (RFI) seeking feedback on establishing the first National Directory of Healthcare Providers and Services (NDH) that could serve as a centralized data hub for healthcare provider, facility, […]
New Accuracy Rules? New Accuracy Tools
Accuracy Gap Analysis Quest Enterprise Services—QES—has always allowed you to manage provider data accuracy and network adequacy together, which is one of the aspects that sets us apart from other solutions in the industry. Our Accuracy Gap Analysis brings a new capability to the table: It lets you easily see the before and after—what-if scenario—of how […]
FAQs and Provider Directory Requirements: Key Tips and Targets
One of the top questions health insurers have asked us lately is: Will I still need to have a provider directory verification process in place by January 1, 2022? Simply put, yes. In this blog, we’re highlighting the essential points you need to know about the FAQs and provider directory requirements. FAQS ABOUT THE PROVIDER DIRECTORY REQUIREMENTS […]
Surprises in the No Surprises Act: New Requirements for Plans and Providers Regarding Provider Directory Information
Copyright 2021 Compliance Today, a publication of the Health Care Compliance Association (HCCA). The No Surprises Act was signed into law in December 2020 as part of the massive Consolidated Appropriations Act of 2021.[1] It is the end result of several prior bills that sought to address the national “surprise bill” problem. In recent years, millions […]
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 […]
