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With a history of innovation, Quest Analytics perform to make sure that their clients comply with the complex and quickly changing state and federal regulations.
FREMONT, CA: "At Quest Analytics, we have a legacy of innovation and are proud of the work we do to ensure that our clients meet the complex and rapidly evolving state and federal regulations. These new enhancements address the need to continuously monitor the accuracy of provider network data and the impact on network adequacy, as well as offer more efficient ways to measure and model networks while ensuring compliance." says Linda Borths, Chief Client Officer of Quest Analytics.
Quest Analytics, one of the leaders in provider network management solutions and services, introduced three new features for Quest Enterprise Services (QES) designed to enhance their client's ability to address the No Surprises Act (NSA) and the evolving provider network regulations. The new offerings include:
Daily Refresh & accuracy API
The add-on option for QES Accuracy ensures that clients receive timely updates for their network providers daily rather than weekly. The No Surprises Act requires employer-sponsored, Marketplace, and individual plans to update their provider directories within two business days of receiving a provider notification that information has changed.
Targeting the volume
Quest Analytics introduces Volume Targeting, which enables clients to quickly and effectively assess the impact that adding a health system or large provider group has on network adequacy requirements across lines of business. Volume Targeting builds on the workflow efficiencies created by Volume Terminations in QES Adequacy last year.
CCIIO QHP template
The CCIIO QHP Template in QES is pre-built based on the new PY 2023 CCIIO federally facilitated exchanges (FFEs) QHP Network Adequacy criteria and allows health plans to monitor provider network compliance easily, identify problem areas in provider networks, and streamline provider recruitment.