Provider Network Management for Dental and Vision Plans | Quest Analytics
Ancillary Benefits Network Management Solutions
THE LEADING PROVIDER NETWORK MANAGEMENT PARTNER
Enhance your network management capabilities with Quest Analytics®, the go-to solution for top dental and vision plans in the U.S. With 30 years of experience in analyzing networks, we’ve established the industry standards for network adequacy that every insurance company relies on. Now, through our SaaS-based Quest Enterprise Services® (QES®), you can easily measure, manage, and monitor all your specialties for both government and commercial programs.
NETWORK ADEQUACY AND PROVIDER ACCURACY FOR YOUR DENTAL AND VISION NETWORKS
QES® provides a comprehensive platform to help you efficiently manage every aspect of your network across various business lines. By using our solution, you can streamline operations, ensure regulatory compliance, and significantly improve the experiences of your members.
Gain A Competitive Edge in RFP Responses
Quest Enterprise Services provides you with a competitive edge when responding to RFPs. You can highlight your network’s strengths based on each client’s specialty utilization, including market share, availability, capacity, and provider directory accuracy. Additionally, you can demonstrate total market accessibility, which helps reduce out-of-network utilization, and accuracy analytics, which helps minimize surprise billings.
RESPOND CONFIDENTLY TO ACCREDITATION REQUESTS
Demonstrating consistency in evaluating and managing network adequacy and provider directory accuracy is essential for accreditation. Quest Enterprise Services helps you respond to requests from agencies like NCQA and URAC. Our platform allows you to assess your network according to required standards and report on its performance over time, ensuring compliance with accreditation criteria.
QUEST DENTAL AND VISION SERVICES
Provide access to the tools and insights your team needs to work more intelligently and more proactively.
TO HELP YOU ENSURE YOUR MEMBERS HAVE ADEQUATE ACCESS TO CARE, OUR SERVICES INCLUDE:
1. Competitive Advantage RFPs
Provide brokers and consultants a real-time view into the adequacy of your commercial network and accuracy of your provider data on a ongoing basis.
2. Provider Data Management Services
Validate your provider network data, while tracking and trending your progress over time.
3. Market Comparisons
Understand the depth of your network and your market share compared to the total availability of providers by specialty.
4. Membership Analysis
Model and assess your network using your own member data, in addition to a beneficiary or census file supplied by a regulator. Also, prioritize filling deficiencies based on the amount of membership at risk.
5. Network Performance Trending
Respond to accreditation agency requests, such as NCQA with confidence by demonstrating an ongoing process and providing a real-time view into network performance over time.
6. Network Adequacy Services
Measure, manage and monitor your network adequacy score in real-time, including the ability to understand how current and future provider contracts impact your network adequacy. Utilize additional metrics on network/prospect providers that you want, such as quality, utilization fields or cost & efficiency data.
7. Accuracy Services
Understand what’s right, wrong and missing within your provider data enabling you to remediate issues, manage any potential impact on your network adequacy and track performance over time.
8. Impact Analysis Services
Fill your gaps more efficiently. View what providers are available in the Market as well as within your other lines of business and their impact on your network adequacy by geography and specialty.
ADEQUACY + ACCURACY IN ONE PLATFORM
By running all of your networks through a single provider network management platform, you’ll gain a better understanding of the strength of your network and the impact of your providers across business lines. You’ll create cross-departmental efficiencies, cut costs and have a realtime lens into how your network compares to the market.
SOLVE YOUR PROVIDER DIRECTORY ACCURACY CHALLENGES TODAY
Our team is ready to help you address the challenges provider data presents. We want to help you take your member experiences to the next level and avoid regulatory risks, like audits, and meet the mandates around surprise billing.
Contact us today to book a strategy session to understand and provide guidance to limit your exposure.