One of the most valued components of a Health Plan’s offering is its provider network. At the same time, it’s also a major pain point for consumers.  Over the years, the provider network directory has been a source of confusion for patients and providers alike.  Determining whether a provider is participating in the network and at which office can be a challenge.  Also, the issues of surprise billing looms large – the hospital is in network, but the anesthesiologist is not.

Management of this dynamic feature in a Health Plan offering is a challenge for the Health Plan as well.  Providers move and don’t update their profiles or practices merge and simply list every provider at every office location.  Maintenance of the provider directory can be a logistical nightmare.

With us today to share how his organization is addressing these and other network issues is Steve Levin, CEO of Quest Analytics.  Quest Analytics helps health plans and other organizations manage access, adequacy and accuracy of networks to help Health Plans not only be compliant, but also to help them maintain a competitive edge.

Show notes:  Life in a Jar: The Irena Sendler Project.  Several books on the civil war, focusing on reconstruction. Remembering the Civil War by Caroline Janney And  Armies of Deliverance by Elizabeth Var