SURPRISE BILLING RESOURCES

Be prepared, not surprised. Explore our Resource Center to learn about the Provider Directory requirements, listed in the No Surprises Act – Section 116 Protecting Patients and Improving the Accuracy of the Provider Directory Information. Find out what’s new and what you can start doing today to succeed.

Federal Update on New Provider Directory Verification Requirements

On July 1, the Biden administration released an interim final rule, “Requirements Related to Surprise Billing; Part I,” to protect consumers primarily insured in the commercial market from surprise billing and balance billing starting January 1, 2022.

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.

Access On-Demand Webinar

Surprise Billing Resource Center

Legislative Brief

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 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.

Surprise Billing one Sheet
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.

Surprise Billing Infographic

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

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

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.

A Health Plan’s Implementation Strategy Guide

James Lamb, our VP of National Payers Segment, coaches you through the four phases of implementing a Provider Data and Directory Verification process.

Understand the Provider Directory Requirements

Eliza Hoffman, our VP of Regional Payers Segment, shares what health plan Network Management teams can do to establish new processes for ensuring provider data and directory accuracy.

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

It’s staggering to think that, according to researchers, 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. These unexpected, costly, and often frustrating charges are aptly called Surprise Medical Bills…

Top 3 Things the No Surprises Act Means for Health Plans

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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