Managing a healthcare provider network requires constant visibility into network analytics and strategic decision-making. QES Volume Terminations simplifies this process by automating network scenario modeling, allowing you to quickly analyze the impact of removing providers from multiple networks simultaneously. By reducing manual tasks and delivering rapid, actionable insights, automation helps you make better decisions and focus on high-impact initiatives.
What is QES Volume Terminations?
QES Volume Terminations helps you analyze provider impacts and gain insights in key areas, including:
- Network Impact: Evaluate the effects on members, lines of business, coverage, and compliance
- Strategic Gaps: Identify potential gaps created by provider terminations
- Provider Details: Understand key attributes like specialty, practice locations, and contracted networks.
Automation and powerful analytics are at the core of helping you plan for growth and success with your provider networks. The ability to quickly evaluate the impact of removing a provider or provider group across Medicare Advantage, Medicaid, and Commercial networks drives efficiency and informed decision-making.
Think of it as having a crystal ball for provider network management. With enhanced speed, precision, and analytics, this tool offers a transformative approach to strategic planning. Let’s explore how it can turbocharge your provider network management practices.
What Can QES Volume Terminations Do For Your Provider Network Management?
Powerful Network Analytics for Proactive Scenario Modeling
Using our advanced analytics, QES Volume Terminations enables you to evaluate the impact of removing National Provider Identifiers (NPIs) or Tax Identification Numbers (TINs) across all your provider networks and lines of business — simultaneously.
In just four simple steps, you gain actionable insights to make informed decisions:
- Identify affected specialties, counties, and lines of business to understand how provider terminations will influence your network.
- Determine the number of gaps created within networks where the provider participates, helping you spot potential challenges.
- Review and compare network adequacy scores for both current and projected networks, ensuring alignment with regulatory and business requirements.
- Plan with confidence, thanks to fast and accurate scenario modeling that eliminates guesswork and supports strategic decision-making.
Tip: Use QES Volume Targeting to identify providers who can fill potential gaps before termination decisions take effect.
Avoid Compliance Hurdles
QES Volume Terminations doesn’t just save time—it also simplifies compliance management. Advanced automation helps you proactively identify gaps resulting from provider terminations, giving you the insights needed to act ahead of time to make informed decisions that ensure compliance with regulatory standards while minimizing risks.
With QES Volume Terminations, you can answer key network adequacy questions such as:
- What would my network look like if I removed providers who haven’t recently attested to their information?
- What would my network look like if I removed providers who have more than 10 locations?
- What would my network look like if I removed all the ghost providers?
Having the ability to anticipate and address compliance issues before they arise empowers you to manage networks thoughtfully and strategically, protecting your organization from penalties and operational disruptions.
Negotiation with Powerful Insight
Negotiations can be tricky, but with QES Volume Terminations, you’ll have a wealth of insight at your fingertips. You’ll be equipped with the analytics to see just how much weight they carry when it comes to contributing to your network. Can you picture yourself walking into that negotiation, head held high, armed with the knowledge you need to make the best decision for your organization? No more hesitating or second-guessing the conversation, you’ll have the data and insights to back up your decisions.
Manage Your Provider Network with Ease and Efficiency
QES Volume Terminations is a must-have for any healthcare network looking to thrive. With this highly effective tool, you’ll have the power to manage your healthcare provider network with ease and efficiency, ensuring maximum value to all stakeholders.
Get ready to simplify your network management—and your work day—with just a few clicks. QES is an easy-to-use network solution that enables you to make faster, smarter, more strategic decisions. Discover what QES Volume Terminations can do for your organization today.
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.
