The Right Framework To Comply With Provider Directory Requirements

New Video

How to Show Compliance with the No Surprises Act

We have the inside scoop on how you, as a health plan, can be in compliance with the No Surprises Act Provider Directory Verification requirements. Zach Snyder, VP of Government Affairs, Quest Analytics, explains the workflow you can use to meet these guidelines and demonstrate that you’re making efforts to be in compliance.

InfoBooklet

The Guide for Accurate Provider Directories

There’s a new era for provider directories and we’re here to help you navigate it. From roles & responsibilities to proven strategies to ProTips, we’re covering everything Payers need to know. Download your copy now to stay ahead of the game.

Planning Worksheet

No Surprises Act Provider Directory Verification Process

Knowledge is power. To prepare for the Provider Directory Verification mandate, you must understand your current processes. Use this worksheet to help you and your team uncover key answers and hit key targets.

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Articles

New Guidance on the Provider Directory Verification Requirements 

The latest guidance stands firm on January 1, 2022, as the effective date. We’ve summarized the highlights and key takeaways.

FAQs and Provider Directory Requirements

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.

Federal Update Review

Requirements Related to Surprise Billing; Part 1

Compliance Today Article

The No Surprises Act was signed into law in December 2020 as part of the massive Consolidated Appropriations Act of 2021. Here are new requirements regarding provider directory information.

Top 3 Things the “No Surprises Act” Means for Health Plans

One in five emergency room visits results in an individual receiving a bill for treatment or services they expected to be covered by their health plan but weren’t.

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Webinars

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.

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Legislative Briefs

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.

Information about Quest Enterprise Services

Adding Value. Reducing Risk. Meeting Compliance.

It can be challenging for health plans to adhere to the requirements for Protecting Patients and Improving the Accuracy of Provider Directory Information. We’re here to help you. Find out how Quest Enterprise Services (QES) can assist you in maintaining accurate and adequate provider networks.

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White Papers

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.

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Infographics

Surprise Billing Infographic
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.

Surprise Billing Infographic 2
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

SurpriseBillingFAQ2-051921
Smart Sheet

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.

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Videos

Learn More With Related Resources

Price Transparency
Insights Article

TRANSPARENCY IN COVERAGE

Legislative Brief *Updated as of 10/13/2021

PRICE TRANSPARENCY FINAL RULE

Deliver on tomorrow’s goals by planning today

Our main priority is assisting you with your day-to-day roles and responsibilities of ensuring accurate provider directories and adequate health networks, in turn, maintaining appropriate access to care for your members. We encourage you to lean on us as much as you need. Each of us at Quest Analytics has the tools and technology to help you and your team meet the needs and goals you have for your Medicare Advantage, Medicaid and Commercial lines of business.

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