APPLETON, Wis., March 19, 2013 /PRNewswire/ — The Network Adequacy requirements for qualifying plans to participate in the Medicare Advantage program are very clear and every plan is held to the same standard. As the final submissions were uploaded on February 21, 2013, plans desiring to become new Medicare plans or expand into new service areas, now have less than 2 weeks to justify why their network may not meet the Network Adequacy requirement and request an exception from CMS.
"The timelines are tight and health plans often struggle to identify if there are providers and facilities located within the published time and distance criteria," states Linda Borths, National Sales Director, Quest Analytics. "The ability to identify those providers who can impact a plans filing is a critical component to their ability to expand to serve additional Medicare enrollees," add Borths.
Quest Analytics provides a Narrow Network Analysis service to help plans solve these deficiencies. This service returns to you a targeted list of available providers and their impact on the Medicare population. The ranked and ordered listing of available providers helps health plans minimize their contracting efforts by understanding the value of every provider to more effectively fill their network adequacy gap. Health plans that have utilized Quest Analytics' Narrow Network Analysis service have enjoyed huge costs savings while gaining CMS approval by contracting with the right providers.
"Using the Narrow Network Analysis services from Quest Analytics takes the guess work out of network contracting," shares David Pavlik, Vice President, Client Services and Technology at Glenridge HealthCare Solutions. "This provides recruiters the power of understanding the value of every provider prior to seeking a contract," adds David.
This process also can provide the validation for those rare situations when there are simply no available providers. If CMS recognizes the relevance and validity of a plan's information about local patterns of care issues, they still need to understand where enrollees will get the needed services. With the Quest Analytics Suite, you can explain where your enrollees would be expected to go to have access to these services and how far they would have to travel to do so.
Quest Analytics has provided powerful software solutions to automate a plans Network Adequacy checks and HSD submissions. The Quest Analytics Suite's Narrow Network Analysis services, exemplifies our dedication to providing powerful solutions to help plans meet their business needs efficiently and effectively. If you've ever imagined giving your recruitment teams more insight to understand the value of a provider, you'll want to contact us for more information, 920.739.4552 or Email.
About Quest Analytics:
David H. Hill and John P. Weis founded Quest Analytics in 2003. Quest Analytics is an independent solutions company built without ties to any health plan. Both Hill and Weis have extensive experience in commercial software development and consulting services for the healthcare industry. Their experience in the industry has brought many innovative solutions to market ranging from; pioneering access analysis and disruption analysis tools to evolving network adequacy solutions and narrow network design services.
Today, Quest Analytics' dedication to providing innovative solutions to challenges facing the healthcare industry continues, and their industry expertise is sought on a national basis.
Contact:
John P. Weis
President & Co-Founder
Email
15 Park Place, Suite 300
Appleton, WI 54913
920.739.4552