New Features to Improve Compliance with Federal Regulations

Accuracy API & Daily Refresh | Volume Targeting | CCIIO QHP Template

OVERLAND PARK, KS (June 30, 2022) – Quest Analytics, the leader in provider network management solutions and services, today introduced three new features for Quest Enterprise ServicesTM (QES) designed to improve their client’s ability to address the No Surprises Act (NSA)QHP Certification and the evolving provider network regulations. The new offerings include:

  • Accuracy API & Daily Refresh: With the No Surprises Act mandate that employer-sponsored, Marketplace and individual plans need to update their provider directories within two business days of receiving a provider notification that information has changed, the new Daily Refresh & API add-on option for Quest Enterprise Services Accuracy ensures that clients receive timely updates for their network providers daily, instead of weekly.
  • Volume Targeting: Building on the workflow efficiencies created by QES Volume Terminations, Quest Analytics introduces QES Volume Targeting, allowing clients to quickly and efficiently evaluate the impact of adding a health system or large provider group on network adequacy requirements across lines of business.
  • CCIIO QHP Template: The CCIIO Qualified Health Plan (QHP) Template in QES is a pre-built template based on the latest CCIIO Federally-facilitated exchanges (FFEs) QHP Network Adequacy requirements. The template enables health plans to monitor provider network adequacy for QHP Certification compliance easily, identify deficiencies in provider networks and streamline provider recruitment.

“At Quest Analytics, we have a legacy of innovation and are proud of the work we do to ensure that our clients meet the complex and rapidly evolving state and federal regulations,” said Linda Borths, Chief Client Officer, Quest Analytics. “These new enhancements address the need to continuously monitor the accuracy of provider data and the impact on provider network adequacy. As well as, offer more efficient ways to measure and model provider networks while ensuring compliance.”


As part of Quest Analytics’ commitment to educating health plans on these regulations, Quest Analytics will host a webinar with AHIP entitled, “Understanding the Network Adequacy Changes in the Medicare Advantage Final Rule,” on August 9, 2022. Scott Westover, SVP Network and Regulatory Strategy, Quest Analytics, will be joined by Michael Adelberg, Principal – Healthcare Providers & Plans Practice Lead at Faegre Drinker Consulting, to discuss the new requirements in the CMS MA Final Rule for CY 2023, provide strategies for meeting the regulation, and share insight into future oversight. Watch the webinar on replay now.

About Quest Analytics

Quest Analytics’ software platform and services are trusted by more than 400 clients, including all eight of the nation’s largest health plans, regulators, including the Centers for Medicare & Medicaid Services (CMS) and multiple state regulatory agencies, and many of the nation’s leading health systems and provider groups to manage, measure and monitor health plan network performance. The company helps 90% of all healthcare networks deliver differentiated member experiences, thereby impacting 90% of Americans’ ability to access quality healthcare.  For more information, please visit www.questanalytics.com.


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