Network Development

We are experts in building and expanding high-performing provider networks, while delivering operationally efficient and cost-effective network management services.

Market Assessment

Regardless of what kind of network you are building, our team starts with a full analysis of the target markets, beginning with a review of the provider universe. We use current market knowledge and data compiled from multiple sources to review the provider landscape (per market). Then we identify provider targets and prepare a Market Scorecard. You will know where you should – and more importantly, should not — expand.

Market Assessment

Provider Network Contracting & Management

Contracting & Reporting

Provider Directory & Data Management

Credentialing

Network Adequacy



Provider Network Contracting & Management

Acting on your behalf or as an extension of your team, we utilize our proprietary software solution to establish a customized, real-time, dynamic database that provides contracting management, document storage, analytics reporting, and facilitates provider repository needs.

Contracting & Reporting

Customizable solutions based on your needs, we can conduct any (or all) of the following contracting activities:
  • Physical mailing of contracts
  • Recruiter outreach/prioritization
  • Contract redlines management
  • Contract status dashboards
  • Network Adequacy status

Provider Directory & Data Management

We align our best practice approach to initiate the provider document management model, that begins when a contract is accepted, our team validates demographic information based on the requirements established by our clients. Our methods of data collection and the frictionless transfer of data to our clients’ systems, reduce errors and ensure that the provider directory is complete, compliant and ready for filing.

Credentialing

We avoid the manual credentialing process that is tedious and error-prone and often causes health plans to incur additional costs by partnering with an industry leading organization to seamlessly integrate credentialing services with our robust Network Development services. Our credentialing partner offers tech-enabled solutions that automate the primary source verification process required to create a fully compliant and credentialed network.

Network Adequacy

Our proprietary technology coupled with available CMS data analyzes adequacy, cost and quality measures to identify priority provider targets. Utilizing these measures ensures that each network is aligned and high-performing. During the recruiting process, we continually re-prioritize your targets, which gives you the straightest path to adequacy and speeds your go-to-market.

Download Whitepaper

HERE