5 Things I Learned at Vision Quest
Admittedly, I’m new to provider network management. I’ve spent years working in healthcare, but this is my first time working with payers from across the nation to improve the access, adequacy, and accuracy of their provider networks. Lucky for me, I got a behind-the-scenes view through Quest Analytics Vision Quest. As a session moderator, I heard […]
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 […]
Quest Analytics Launches Quest Enterprise Services
First to launch platform enabling health plans to simultaneously measure, manage and monitor network adequacy AND directory accuracy. OVERLAND PARK, Kan., June 16, 2020 – Quest Analytics, the leader in measuring, managing and monitoring health plan network performance, today announced the release of Quest Enterprise Services (QES), the first and only platform to enable the health plan community to […]
Health Plan Best Practices to Comply with SB-137
When we say the strictest provider compliance law in the country, we’re not kidding. Although other state and federal regulators, the Centers for Medicare & Medicaid Services (CMS) for example, are starting to incorporate rules around provider directory data, SB-137 requires health plans to reach out to all contracted providers on a quarterly basis to […]
Though Agency Released No New Policy, CMS Says Inaccurate MA Provider Directories Raise Network Adequacy Issues
Reprinted from the April 3, 2019, article in Inside Health Policy. CMS emphasized the importance of accurate provider directories for Medicare Advantage plans, saying that inaccuracies can bring plans’ network adequacy into question, but did not finalize new policy to improve the directories as part of the MA and Part D call letter for next year. […]
The Health 202: Trump Administration Lets Medicare Plans Off the Hook
Reprinted from the December 4, 2018, article in The Washington Post THE PROGNOSIS The Trump administration is holding off on punishing Medicare Advantage plans for error-ridden doctor directories — further evidence the conservative-led Centers for Medicare and Medicaid Services is showing special favor to the alternative program over traditional Medicare offerings. In an audit quietly released late […]
Medicare Advantage Provider Directories Are Still Systemically Inaccurate
Reprinted from December 4, 2018, article in Modern Healthcare Federal audits of Medicare Advantage plans’ provider directories have revealed sweeping inaccuracies for the third straight year, raising the specter of fines or other penalties for the insurers. Nearly 50% of provider directory locations showed at least one mistake in the latest audit results, the CMS said […]
Quest Analytics Presents New Combined Network Adequacy and Accuracy Solution at AHIP Institute 2018
Last week, Quest Analytics’ CEO Ari Tulla and President and Co-Founder John Weis presented a newly combined network adequacy and accuracy solution for health plans during a session at AHIP Institute 2018. This conference brought together key healthcare industry players including health plans, health groups, policymakers, and providers in San Diego. The combination of Quest Analytics’ network decision-support tools […]
What Would Provider Data Management Look Like on Blockchain?
Join us to take a deep dive into blockchain on May 1-2, 2018 at Washington Plaza Hotel, Washington D.C. Our CTO Tapio Tolvanen is going to speak at Healthcare on the Blockchain conference, in Washington D.C. next week. The panel discussion, entitled “Managing Data on the Blockchain for Cost-Savings and Error Reduction“, will be held on May 2 at […]
