Provider Data Accuracy Resource Hub

Latest Health Policy Episodes

Episode: Unlocking the Value of Network Performance Data
Guest on: Becker’s Healthcare Podcast Unlocking the Value of Network Performance Data Bob Tavernier of Quest Analytics® and Karen Tachian of Health Care Service Corporation discuss network performance in health...
Episode: Driving Network Adequacy for Dual Eligibles: Overcoming Challenges and Delivering Solutions
Driving Networks Adequacy for Dual Eligibles: Overcoming Challenges and Delivering Solutions Guests:  Zach Snyder, JD, MPA, Quest Analytics | Connect on LinkedIn  Tricia Beckmann, JD, Faegre Drinker | Connect on...
Episode: The REAL Health Providers Act: What Health Plans Need to Know
Episode: Health Policy Updates April 2025 The REAL Health Providers Act: What Health Plans Need to Know Topics Covered Are health plans prepared for the sweeping changes proposed under The...

Provider Data Accuracy Policy News & Insights

How to Comply with California Provider Directory Requirements
California has been at the forefront of regulating provider directory accuracy, including addressing ghost networks. Every health plan in California must maintain updated directories of in-network healthcare providers for their...
Health Policy Trends Across Markets
As the healthcare industry continues to transform, regulators and policymakers are increasingly working to enhance the standards that govern it. This dynamic environment is driven by a strong commitment to...
Increasing Provider Data Accuracy Oversight Across Healthcare Markets
Increasing Provider Data Accuracy Oversight Across Healthcare Markets Stay Informed with the Latest Regulatory Updates and Trends Federal and state regulators are actively amending network adequacy and provider directory accuracy...
Network Adequacy and Provider Directory Accuracy Policy Updates
Federal and state regulators, along with lawmakers, are actively amending network adequacy and provider directory accuracy requirements while intensifying oversight. These changes have far-reaching implications for medical and ancillary plans....
The Requiring Enhanced & Accurate Lists of Health Providers Act
Are enrollees receiving the healthcare services they were promised? Inaccurate provider directories and ghost networks have been longstanding concerns in the healthcare industry, particularly with mental health services. Recognizing the need...
Executive Order on Healthcare Price Transparency
The executive order, “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Health Care Pricing Information,” has understandably created buzz in the health care industry. This policy...

Interactive and Downloadable

Provider Directory Accuracy Assessment Toolkit
Provider Directory Accuracy Assessment Toolkit Ensure Your Provider Directory Meets Regulatory Standards To meet diverse regulatory requirements, healthcare organizations must ensure provider directory accuracy. This involves developing and implementing documented,...
The Guide for Accurate Provider Directories
The Guide To Provider Data Accuracy Download Now! Provider Data Management Tips And so it begins, the new era for provider directories. From roles & responsibilities to proven strategies to...
How to Comply with Provider Directory Rules
How to Comply with the Provider Directory Verification Requirements No Surprises Act Requirements The No Surprises Act has brought a new level of scrutiny to health plans. Now, it’s not...
The Impact of Provider Data Accuracy on Network Adequacy
The Impact of Provider Data Accuracy on Network Adequacy Download Now! Revealing the Powerful Link between Provider Data Accuracy and Network Adequacy Managing a health plan provider network is like...
5 Best Practices: Improving Provider Data Accuracy, Provider Outreach and Outcomes
Everyone’s buzzing about improving provider data accuracy and transparency these days—and for good reason. Just like an athlete training to reach peak performance, healthcare professionals like yourself need the right...
Provider Outreach and Verification
A Proven Approach to Provider Data Accuracy Download Now! Simplify Provider Data Verification with Attester-Driven Rolling 90-Day Outreach Are you a health plan professional striving to improve your provider verification...

Ghost Networks Insights & Analysis

Ghost Networks in Healthcare: What They Are and How To Address Them
Ghost networks have increasingly become a central topic in discussions within the healthcare sector and legislative circles. As this issue gains attention, it is crucial to understand the implications of...
The 5 Hidden Costs of Ghost Networks
Effective cost management is paramount for healthcare organizations, yet the issue of ghost providers remains a significant contributor to avoidable expenses. Through an analysis of the financial implications associated with...
The Requiring Enhanced & Accurate Lists of Health Providers Act
Are enrollees receiving the healthcare services they were promised? Inaccurate provider directories and ghost networks have been longstanding concerns in the healthcare industry, particularly with mental health services. Recognizing the need...

Provider Data Management Tips to Successfully Meet the No Surprises Act

Health plans must have a documented, defendable process in place to show the effort they’re making to comply with the provider directory verification requirements. What should this process look like? We have the answer! 

FAQs and Provider Directory Requirements: Key Tips and Targets

We answer the most frequently asked question that health plans are asking us regarding the CAA Provider Directory Requirements. We also share tips and targets to help you get ahead in the coming months.

The Hottest Trends across health insurance markets

The data is in—and it’s clear: provider network oversight, provider data accuracy and provider data transparency are the hot trends across all health insurance markets. Find out what this means for you.

On-Demand Webinar: AHIP & Quest Analytics Present

STAY AHEAD OF NEW PROVIDER DIRECTORY REQUIREMENTS

Quest Analytics partnered with AHIP to continue the conversation about the new Provider Directory Verification requirements listed in the No Surprises Act. Watch now and learn about:

  • The new provider directory accuracy requirements for health plans and providers
  • The impact the requirements have on your business
  • Which strategies to implement now

Access On-Demand Webinar

On-Demand Webinar

No Surprises Act: What You Need to Know and Why

The No Surprises Act includes regulations that will affect most of our health plan clients. As many are just learning about the new provider data requirements, we want to share the cliff notes and answer the most common questions. Watch the on-demand webinar to learn best practices, strategies, and actionable steps you can take today to align with the new federal requirements.

The New Provider Directory Accuracy Mandate

Under the No Surprises Act, commercial, qualified health plans (QHPs), and employer-based health plans are required to maintain accurate provider directories. Read our legislative brief to learn about the new requirements that health plans and providers need to meet.

White Paper

Surprises in the No Surprises Act for Health Plans and Providers

The new provider directory verification requirements continue to surprise most health plans and providers. Discover what each party needs to do to update the provider directory, and how to design your process to comply with the accuracy requirements.

Best Practices

Implementation In Four Phases

There is a lot to consider and accomplish as you prepare for the mandate. Where do you begin? What happens next? What is a realistic timeline? We’ve mapped out the process for you. Download the Four Phases of Implementing a Provider Data Verification process.

Best Practices

Eleven Questions to Ask Your Teams

As a best practice when preparing for the Provider Data and Directory Verification mandate, it is imperative that you understand your current process. Download the top eleven questions we recommend you ask your teams

Best Practices

Frequently Asked Questions

Section 116: Protecting Patients and Improving the Accuracy of the Provider Directory Information, requires health plans and providers to work together to maintain up-to-date provider directories. Discover the answers to the top questions about the new requirements.

LEARN MORE WITH RELATED RESOURCES

Insights Article

TRANSPARENCY IN COVERAGE

Insights Article

TRANSPARENCY IN COVERAGE

Schedule Your Complimentary Strategy Session

Compliance isn’t our name, but it sure is our game! Learn how we can assist your efforts to make your provider data accurate and network adequate. Book a complimentary strategy session with a Quest Analytics expert to get started on your quest for success.

 

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