androsInsights

Take deep dives into credentialing, provider network management, and healthcare administration news, best practices, and technology with expert members of the andros team.

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Celebrating #OneTeam: andros Spring MVPs

Celebrating #OneTeam: andros Spring MVPs Each quarter we acknowledge the team members who went above and beyond in their role and who exemplified the andros values. All MVP winners are nominated by their peers or manager and the People Team identifies the MVPs (and some honorable mentions!) for the quarter based on these nominations. We love this opportunity to recognize

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Breaking Through Provider Fatigue: How andros Uses Data and Analytics to Build Better Medicare Advantage Networks

Since its launch by CMS, Medicare Advantage (MA) has transformed healthcare in the United States. As a result, Medicare beneficiaries now have more options and insurers are competing on price and quality, which has led to lower healthcare costs and better healthcare outcomes. It seems like a win-win scenario for health plans and consumers… until you recognize which group is

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Meet Our Compliance Expert: Mark Hirschhorn

Meet Mark Hirschhorn, the Director of Compliance at andros. Since 2019, Mark has been an integral part of the andros team, working closely with all departments to ensure compliance with the National Committee for Quality Assurance (NCQA) standards and measures. His responsibilities include providing clients with guidance and support in areas such as policy and procedure development, delegated credentialing applications,

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Why improving the credentialing experience for providers matters

The 90 days plus time taken [for credentialing] is not acceptable. No one at the insurance company is available… emails are not responded to for many many days… talking to different people has no results. -Anthony D., healthcare provider When you ask a consumer what they think of the experience of procuring and receiving healthcare, chances are you’ll hear some

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Employee Spotlight: Julie Dzurilla

Julie is a talented leader and executive with a remarkable history of success managing and transforming large healthcare operations. As the Vice President of Operations, Julie leads the team responsible for optimizing processes to deliver an exceptional customer experience for clients.  Julie has a strong background in credentialing and operational expertise and has been a great mentor to her team.

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Winter Newsletter: Note from Mike Simmons

As I reflect on the accomplishments of our team over the last year, I’m proud that we were able to end the year on a strong note. Our mission to provide the best credentialing services for our clients remains unchanged. We have far exceeded industry standards, with faster turnaround times and more reliable results. As we look ahead, we remain agile and prepared to adjust for an ever-evolving market.

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NCQA Credentialing Requirements

One of our goals for our blog is to demystify credentialing so we are creating a series especially for leaders and business process owners who want to gain a deeper understanding of the NCQA standards and credentialing guidelines but don’t have time to wade through 100 pages of regulations. In this series, we’ll break down what you need to know about credentialing,

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Credentialing Issues in Healthcare

Credentialing is the process of verifying the qualifications and credentials of healthcare professionals in order to ensure that they are qualified to provide patient care. This process is critical for maintaining the quality of patient care and for protecting the public from unqualified practitioners. To combat the potential for intentional or unintentional data inaccuracies in the information provided by healthcare

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How to automate provider credentialing

Credentialing plays a critical role in helping ensure that patients receive quality care from fully qualified professionals. Whether a provider applies to join a particular healthcare network or the network recruits the provider, the health plan–or any other healthcare payor offering services–must verify the provider’s credentials. Because of the legal and regulatory consequences that could ensue from healthcare decisions and

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The Inadequacy of Network Adequacy

CMS plays a critical role in establishing adequate standards for healthcare, especially for the underserved. This means that those who need care should be able to get it, when they need it, without unnecessary barriers preventing access to quality care. But how do those standards play out in real life? Download The PDF

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What does good provider network management look like?

The challenges of building a provider network are well-known in the healthcare industry. Network development teams must identify sufficient healthcare providers and facilities within a geographic area to meet patient needs, then recruit, contract, and credential them. If they’re building a network for Medicare or Medicaid patients, meeting adequacy requirements and submission deadlines complicate the calculations required. Only then can

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Case Studies

ACO Case Study

An Accountable Care Provider (ACO) had multiple challenges, including missing growth targets, inability to collect or analyze recruitment data, and having slow recruitment processes. andros helped to educate providers, generate new revenue, and automate data collection, storage and analysis.

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Celebrating #OneTeam: andros Fall MVPs

Celebrating #OneTeam: andros Fall MVPs Each quarter we acknowledge the team members who went above and beyond in their role and who exemplified the andros values. All MVP winners are nominated by their peers or manager and the People Team identifies the MVPs (and some honorable mentions!) for the quarter based on these nominations. We love this opportunity to recognize

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Q3 Primary Care Provider Market Study

“ Primary care providers are more interested in acquiring new patients with their existing health plan contracts then they are in signing contracts with additional health plans ” andros executed our Q3 Provider Market Study to better understand primary care provider sentiment around network contracting and access to specialist providers for their patients.  Part of what compelled us to focus

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Becoming a Medicare Advantage Plan of Choice for Providers

Effective, high-performing providers are the lifeblood of a successful healthcare network. When they’re not worried about things like paperwork and reimbursements, providers can focus on their patients and deliver quality care. On the flip side, providers who spend too much time behind a desk, dealing with administrative headaches rather than treating patients, struggle to do so. In the increasingly competitive

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Improving the Patient Experience Using NCQA Report Cards

NCQA, the National Committee for Quality Assurance, is very clear about its mission: “We work for better health care, better choices and better health.” One tool they use to improve care is the NCQA report card program. NCQA report cards evaluate clinicians, practices, and health plans on a simple five star grading system. Since NCQA issues report cards for health

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Fall 2022 Newsletter: Note from Mike Simmons

As we progress through the 4th quarter of 2022 and start looking ahead to 2023, change is again in the air. We are committed to becoming ever-better partners to our customers. For me living that commitment means talking to our customers and in Late August I set a goal of meeting with 30 customers over 60 days — it’s been super rewarding.

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