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 and analytics to identify the right providers for inclusion so that the resulting networks better meet business requirements and member needs while also reducing administrative costs.
“Provider Claims Insights was built with our clients’ direct input to improve their understanding of each provider’s practice – their mix of business and relative cost and quality,” Steve Levin, CEO, Quest Analytics. “This type of more detailed insight allows superior network composition improving member satisfaction while maintaining critical access and network adequacy.”
Benefits of Using QES Provider Claims Insights
- Identify ghost providers and ensure true access for members.
- View a provider’s clinical activity by the line of business relative to other providers in their specialty and geography.
- Understand a provider’s payer mix by line of business, providing insight into a provider’s relationship with all health plans in a given market.
- Gain insight into relative performance among physicians through cost and quality metrics.
- Make more informed gap-filling decisions by knowing each provider’s top procedures and conditions.
- Reduce costs associated with contracting and managing non-productive providers.
More Resources on Provider Network Optimization
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Looking to simplify your workload? Let Quest Analytics take on the heavy lifting! Our solutions and dedicated team specialize in provider data accuracy and provider network adequacy for various lines of businesses, including Medicare Advantage, Medicaid and Commercial. Schedule a strategy session today and see how we can help you every step of the way.
