Innovation Area #1: Data Transparency
Managing provider network data is crucial for healthcare organizations, and we’re committed to making it easier for you. That’s why we’re introducing innovations in data transparency. By sharing a holistic view of valuable data insights across your organization, you’ll have the critical information you need to manage your provider networks efficiently.
API Enhancements: Opening New Possibilities
🥁 Cue the drumroll! Presenting our Quest Enterprise Services Accuracy API enhancements!
What makes them so incredible? For starters, faster data retrieval. Say you’re on a mission to track down providers who haven’t attested to their information in the last 90 days or you need to understand a particular specialty. Piece of cake! Our API lets you get answers quickly.
By removing unnecessary data from API results, you can develop your internal business logic and data-handling software more efficiently and in less time. And did we mention compliance? Our API can help you meet provider data accuracy regulations as well! ✅
Plus, these enhancements make it easier for your I.T. team to implement our API. Who doesn’t appreciate a low-stress integration experience, right?
Want to learn more? Contact us today to dive deeper into the endless possibilities of our Accuracy API!
Advanced Analytics, Reporting, and Visualizations: Provider and Location Status
When managing your provider and network data, you need more than a surface-level understanding. With Quest Enterprise Services, you have access to a granular view of your provider data, enabling you to make well-informed decisions. But we understand that sometimes you need a high-level overview of a practitioner’s or service location’s status. That’s why we are working on reporting innovations that will provide you with a bird’s eye view, making it easier to obtain high-level insights.
Here are some of the highlights you can expect:
🩺Practitioner Status: Is the practitioner active, retired, or deceased? Is the NPI deactivated? You’ll have the answers at your fingertips.
🏥 Service Location Update: Is the location open or closed? If the location moves, where is the updated location? You’ll get the latest scoop.
💼 Practitioner Presence: Is the practitioner still operating at the service location? No more confusion or miscommunication.
🔒 Attestation Details: What was the last date of the attestation and how was it obtained?
Group Rosters: Vanishing Acts, Be Gone!
In the realm of group rosters, one of the biggest challenges is dealing with practitioners who mysteriously disappear from one roster to the next. You can expect reporting innovations to identify these elusive providers. Our commitment to transparency extends beyond identification. We’re also taking steps to clarify and address vanishing acts when we spot them. 🕵️♀️✨
How Quest Analytics Improves Provider Outreach and Provider Data Accuracy
Break the mold and step into a new era of provider outreach and verification! Steve Slaton of Quest Analytics reveals the secrets behind our Attester-Driven Rolling Attestation Outreach. It’s time to bid adieu to quarterly uncertainty and welcome a consistent, reliable process that keeps you on track. ✅ Don’t miss out on our innovative approach that improves provider data accuracy and takes your attestation game to new heights.
Innovation Area #2: Timely Provider Data Updates
Staying informed about the latest provider details is crucial for making vital decisions. That’s why we’re expanding our bag of tricks to provide you with the latest data details in a flash! When you’re equipped with the right data, you can ace those pivotal decisions for your organization.
Attester-Driven Rolling Attestation Outreach: Breaking the Mold
Let’s talk about rolling attestations. 🔄 You know the drill—contracted providers need to verify their information regularly. Some may need to verify and attest every 90 days, while others might require it more frequently. Conventional wisdom suggests quarterly outreach would net those valuable attestations, but in the real world, things aren’t always that simple.
The problem arises when you stick to a once-a-quarter approach instead of taking into account a true 90 days. The time between your request and their response can be as unpredictable as a reality TV show.
- You kick off your outreach at the beginning of the first quarter, and voila! Providers respond right away. Fantastic, isn’t it? You think you have the timeline under control.
- Fast-forward to the second quarter, and it’s a different story. You start the outreach process late in the quarter, and providers aren’t as responsive as before. You quickly realize meeting the 90-day timeframe won’t be possible.
That’s where innovation steps in.
We have developed a groundbreaking, individualized, and dynamic approach that adapts to attestor behavior. Introducing rolling attestation—a method designed to elicit an attestation every 90 days based on the last time we received that attestation.
When we receive an attestation from a provider, we restart the clock based on the time we received that attestation. By implementing this proven strategy, you can avoid irregularly spaced attestations that range from 120 to 180+ days apart. Our rolling attestation approach allows for a more consistent, reliable, and efficient process. Helping you maintain a defendable provider verification process and improve provider data accuracy. 🎯
Dynamic Refresh Provider Portal: Saving You Time
Wasting time backtracking or redoing work is the last thing providers and administrative staff want when going through the attestation process. That’s why we’re laser-focused on innovating our system to create an environment where the attestor can access the most up-to-date and reliable information when verifying and updating the information. Time is precious, and we’re here to save it.
Innovation Area #3: Ease Of Use
Do you find updating information in twenty different portals overwhelming? We understand how you feel and have designed our system with you in mind! Our team is constantly working to streamline workflows, making it easy as possible for you.
Location-Centric Outreach: Keeping Your Provider Directories Spot-On
One of the biggest challenges with provider directories is when practitioners are listed at the wrong location. It’s a complex issue, but we’re on top of it! Our location-centric outreach approach addresses this head-on. We contact service locations, specifically asking about practitioners believed to be there to ensure accurate and updated provider data, ready to serve your community.
Streamlining Multiple Location Practices: Saving You Time and Effort
Managing multiple-location practices can be a complicated juggling act. To simplify things, our team is looking at an innovation that bundles those outreaches together. With this feature, when attestors log in to make updates, they can review and attest to all the practice locations in one go. It’s efficiency at its finest!
Large Group Recruitment: Taking Exceptional Service to the Next Level
For those big players in the healthcare industry with countless locations and practitioners, we’ve got your back too! Our streamlined white glove concierge service is already in place to offer exceptional service. Now, we’re taking it up a notch by automating our outreach to organizations that haven’t joined our program—making it easier for them to get started and enjoy the benefits of our provider attestation service.
Innovation Area #4: Machine Learning
Provider network management teams are currently facing the challenge of provider suppression, which is when providers don’t actively engage or attest to their information and as a result, those providers need to be removed from the provider directory. To tackle this challenge, health plans are exploring alternative approaches to determine the accuracy of information about non-responsive providers. We believe this is one of the ways machine learning can shine.
Overcome Provider Suppression: Alternative Approaches
How does machine learning help? With AI & Machine Learning, we can look at various data elements beyond direct provider feedback. By analyzing these signals, we can predict confidence scores to answer crucial questions like:
Does the provider actually practice at the location listed?
Which of the listed specialties is correct?
By applying machine learning to provider data this way, it helps you make informed decisions about the inclusion or exclusion of a provider from the directory.
Stay Connected and Explore the Future with Us
We are thrilled about the exciting prospects for provider network management. Keep an eye out for more updates from us on the latest developments in healthcare innovation and management strategies.
In the meantime, if you’re interested in learning more about the Quest Enterprise Services Accuracy or our other innovative offerings, don’t hesitate to contact us. We’d love to hear from you and explore how we can help you with all your needs and goals. 💬📞
Want to learn more about the future of Quest Enterprise Services Adequacy? Read all about it in this blog: Quest Enterprise Services Adequacy: Driving Provider Network Efficiency with Future Innovations
More On Provider Data Accuracy and Network Adequacy
Stay up-to-date on the latest developments and best practices in provider data accuracy with these valuable resources! We’ve rounded up some of the most helpful articles on current network adequacy and provider data accuracy rules to help you navigate the changing landscape. Dive in now!
Proven Solutions for Your Provider Network Management
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.