Quest Analytics™ Launches Provider Claims Insights Integrated into Quest Enterprise Services™ (QES™)

New offering provides health plans with critical provider insights to improve network composition and performance

PORTLAND, Ore., June 14, 2023 /PRNewswire/ -- Quest Analytics, the leader in provider network management solutions and services, today announced the launch of Provider Claims Insights. This new offering adds provider performance measures within the Quest Enterprise Services (QES) platform to help health plans improve provider selection and overall network performance. Provider Claims Insights gives network teams the tools and analytics to identify the right providers for inclusion so that the resulting networks better meet business requirements and member needs while also reducing administrative costs.

"Provider Claims Insights was built with our clients' direct input to improve their understanding of each provider's practice – their mix of business and relative cost and quality," Steve Levin, CEO, Quest Analytics. "This type of more detailed insight allows superior network composition improving member satisfaction while maintaining critical access and adequacy."

QES Provider Claims Insights, based on a curated national claim dataset, helps clients:

• Avoid ghost providers and ensure true access for members.
• View a providers' clinical activity by line of business relative to other providers in their specialty/geography.
• Understand a providers payer mix by line of business, providing insight into a provider's relationship with all health plans in a given market.
• Gain insight into relative performance among physicians through cost and quality metrics.
• Make more informed gap-filling decisions by knowing each provider's top procedures and conditions.
• Reduce costs associated with contracting and managing non-productive providers.

To see how Quest Enterprise Services and Provider Claims Insights can transform your provider network management strategy, visit the Quest Analytics booth #1717 at AHIP 2023 in Portland, Oregon. Additionally, Quest Analytics' Chairman, Roger Holstein, will lead a session on June 14, 2023, from 11 a.m. - 11:45 a.m. PST entitled, Cacophony or Symphony: Eliminating Bias and Noise to Improve Outcomes, that will explore how bias and noise in decision-making lead to unintended consequences and greater variation in care. For more information, please visit Quest Analytics' AHIP page.

About Quest Analytics  
Quest Analytics' software platform and services are trusted by more than 400 clients, including all eight of the nation's largest health plans, regulators, including the Centers for Medicare and Medicaid Services (CMS) and multiple state regulatory agencies, and many of the nation's leading health systems and provider groups to manage, measure and monitor health plan network performance. The company helps 90% of all healthcare networks deliver differentiated member experiences, thereby impacting 90% of Americans' ability to access quality healthcare. For more information, please visit Quest Analytics.

SOURCE Quest Analytics

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