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Innovation in Network Design

Posted by on Sep 27, 2018 in Uncategorized | 0 comments

WHAT IS A MICRO NETWORK? While we’ve been hearing about narrow networks for a few years now, there are new innovations in network design emerging – enter the micro-network. To continue reading about innovation in micro-network design and find out what micro-networks are and how they compare to narrow networks, click here or...


Posted by on Jul 25, 2018 in Uncategorized | 0 comments

Zelis Network Analytics collects provider network data from hundreds of plans for thousands of provider networks. By aggregating this provider data, we can paint a picture of the medical provider landscape in the United States. To read more about the State of the Market, click here or visit...

Pinning Down the Provider-Location Dilemma

Posted by on Jan 5, 2018 in Uncategorized | 0 comments

Our theme of data quality and directory accuracy continues. This time we are focusing on the most common provider directory error – inaccurate provider-locations. Location inaccuracies occur when a provider does not actively practice at a location where they are listed in a directory. While inaccurate provider-locations cause headaches for members, they also cause problems for both network...

Data Quality & Directory Accuracy

Posted by on Sep 19, 2017 in Uncategorized | 0 comments

introduction Regulatory changes require new ways to look at provider data quality and the accuracy of directory data. The Centers for Medicare & Medicaid Services (CMS) recently completed its first review of Medicare Advantage (MA) online provider directories. The review found that providers were not located at about 31% of the locations listed in directories.[1] Retired and deceased...

Dental Data Quality & Directory Accuracy

Posted by on Aug 1, 2017 in Uncategorized | 0 comments

introduction Directory data accuracy is in the spotlight now more than ever. In the dental industry, a major pain point is network inflation by access points as carriers race to market the best network access for their members. We hear a lot of complaints from our dental customers about this issue but maintaining accurate provider directories is a complex and resource intensive task. The Centers...

Exploring Network Transparency Part II

Posted by on Feb 27, 2017 in Uncategorized | 0 comments

Introduction Click here to download the Issue Brief, Exploring Network Transparency Part II (PDF). In April of 2016, we took an in-depth look at the Centers for Medicare & Medicaid Services (CMS) rule about adding “network breadth” ratings to in our blog post, Exploring Network Transparency. By 2017 Open Enrollment, CMS settled on publishing the network breadth ratings in four...