Quest Analytics BetterDoctor : Roster ®

Solution for Provider Directory Attestations FREQUENTLY

ASKED QUESTIONS

General Questions

® What is the BetterDoctor Roster Solution?

Quest Analytics BetterDoctor^® Roster Solution is designed for large groups and health systems to help ensure compliance with CMS and the No Surprises Act, which require providers to attest to their demographic information every 90 days with all contracted health plans.

Through the roster solution, you can submit provider data at least once every 90 days for distribution to all of our contracted health plans.

Who is eligible to participate?

Large provider groups and health systems of at least 20 practitioners or 5 facility locations may submit a roster in place of receiving BetterDoctor^® attestation outreach.

Does BetterDoctor provide credentialing services?

BetterDoctor collects and processes roster attestations for payer provider directory purposes. We are not involved in credentialing providers for contracting or billing purposes, nor are we able to process add/change/term requests.

Will BetterDoctor update payers’ directories?

BetterDoctor only collects and processes provider directory attestations on behalf of our payer clients. Your payer(s) are responsible for updating their directories based on the attested data we collect and share with them.

I’m still receiving standard BetterDoctor outreach after submitting an initial roster. What should I do?

Once your roster has been processed, any standard outreach requests you are currently receiving should cease within 2-3 days.

If you continue to receive standard BetterDoctor outreach, please forward the request(s) to your Roster Team representative or to rosters@questanalytics.com so that we may investigate and address the issue.

What if a roster is not submitted every 90 days?

If an updated roster is not received at least every 90 days, your providers and/or service locations will be reverted to receiving standard BetterDoctor outreach via email, fax, direct mail and/or phone calls. Rosters should be sent to rosters@questanalytics.com, or if you have a monthly or quarterly distribution list, feel free to add our email to that list.

To help ensure your rosters are submitted on time, we will send you automated email reminders 2 weeks prior to your due date and additional reminders if your roster is late.

Which payers will see the roster attestations?

Please reach out to your Roster Team representative or rosters@questanalytics.com to discuss which payers your attestations will be shared with.

How much does it cost to participate in the roster solution?

There is no cost to participate in the BetterDoctor roster solution, and you can opt out at any time. Participation stipulates submitting a roster at least every 90 days. If a roster is not received, your group will be reverted to receiving standard BetterDoctor outreach.

How does BetterDoctor keep our roster data secure?

The information that BetterDoctor collects is generally available in the public domain and does not require additional security measures. However, if your roster contains Personally Identifiable Information (PII), please know that Quest Analytics^® is HITRUST Certified, which ensures that our organization follows the latest security and privacy standards for the healthcare industry.

Our group already submits rosters directly to our payer(s). Why do we need to submit a roster to BetterDoctor?

You should continue to submit rosters directly to payers with which your organization is contracted per their specific requirements. BetterDoctor’s focus is on verifying providers’ demographic information for publication in health plan provider directories, not for credentialing or billing purposes. Credentialing and billing information is intended for business purposes between your organization and health plans, while accurate demographic information helps health plan members identify in-network providers and avoid out-of-network surprise billing.

What if our group has already attested with CAQH? How is BetterDoctor different from CAQH?

Submitting a Roster

Over 40 health plans contract with BetterDoctor to conduct outreach and collect quarterly attestations for all their contracted providers. Those health plans then update their provider directories with the verified information collected through this ongoing process, thereby guiding health plan members to in-network providers. BetterDoctor does not partner with CAQH and is unable to obtain data from CAQH.

Can we submit an existing roster?

You are welcome to repurpose an existing roster as long as it contains the minimum required data elements. You can contact us at rosters@questanalytics.com to discuss our required data elements.

Should all providers be published in the directory?

The purpose of the Publish in Directory field is to help health plan members identify which in-network providers they may schedule with, and at which locations.

For practitioners who may be listed at locations primarily for billing/credentialing purposes but do not routinely see patients/accept appointments there, please mark them as “No”. Additionally, certain specialties that do not accept direct patient appointments but must still be in the directory for transparency, should also be marked as “No”.

Which providers and/or locations should be included in the roster?

If your providers practice at multiple locations and/or are contracted with multiple payers, we encourage you to send a comprehensive roster of all providers at all service locations. This might include providers who are locum tenens or providing temporary coverage at some locations (note: these providers should also be marked as “No” for Publish in Directory). We match roster data to payers’ network files, so if a provider or location is on a payer’s network file, it would require an attestation.

Should we include termed providers?

You may include termed providers along with their term dates. However, please ensure the termed providers are appropriately indicated as termed to avoid being attested as active providers accepting patient appointments. And always contact your contracted health plans directly to notify them of provider terms as well.

What if my roster includes more than the required data elements?

You are welcome to include additional data elements on your roster. The optional data elements listed on our Roster as Attestation Agreement (RAA) are passed along to payers. Any other data elements included in your roster but not listed in the required or optional data elements list will not be shared with payers.

Are we able to make corrections after a roster has been submitted or can we submit a change report instead of a full roster?

BetterDoctor cannot process change reports, but your information is updated with each roster submission. Should you need to make changes or corrections after submitting a roster, simply submit a new, full roster reflecting the changes/corrections. Please continue to comply with the requirements of your contracted payers for roster submissions as well.

How does BetterDoctor validate roster attestations for accuracy?

There are two avenues for validating your roster data:

• Independent Call Audit: primary source verification calls to independently verify the accuracy of the roster data, mimicking CMS audit protocols (accurate is ≥90%)

• Roster as Attestation Agreement (RAA): informal agreement that allows us to accept your roster data as accurate and attested. The only condition is that you continue to submit an accurate, updated roster at least every 90 days. The RAA is the equivalent of the attestation statement individual providers complete in the BetterDoctor portal when attesting.

If you are highly confident in the accuracy of your provider and location data, you may elect to submit our RAA as a substitute for call audits. Smaller groups, groups with centralized appointment scheduling phone numbers, behavioral health groups, and specialty groups that do not typically accept direct patient appointments (e.g. pathology, anesthesiology, radiology, emergency medicine and hospitalists) are required to submit an RAA in place of a call audit due to inherent challenges in conducting call audits in these scenarios.

What happens after I submit a roster?

Upon receipt of your roster, we’ll perform data quality checks to ensure all data is complete and formatted correctly. We’ll report back if we need any clarification. Once your roster has been processed, any standard outreach requests you are currently receiving will cease.

You will also receive automated email reminders from rosters@questanalytics.com when your next roster is due every 90 days.