Provider Network Adequacy Monitoring
Achieving Network Adequacy for Your Healthy Provider Ecosystem
Automated, full-time network monitoring combined with data-learning ensures that your provider network remains complete and compliant once it’s active. We’re here to help you thrive.
How It Works
Achieving Provider Network Adequacy & Monitoring Compliance in 4 Steps
Think of andros as an extension of your team, connecting the lines of communication among disparate departments so we’re all working towards the same goal: a provider network functioning at peak performance. Compliance monitoring is accomplished in 4 simple, but significant steps.
Testing for Adequacy & Compliance
First things first, our team takes a look at your full provider network to identify any potential issues that may threaten your networks’ state or federal adequacy compliance. Avoiding these issues means avoiding fines and penalties that can threaten your plan’s long-term success.
Filling the Gaps
Once we’ve identified the gaps, we identify and prioritize the providers who will be the most suitable replacements. But this isn’t just about ensuring compliance — our platform identifies the most desirable providers to help make your network as efficient as it can be to best serve members.
Recruiting and Contracting
Our team of specialized professionals manage the recruiting and contracting phase on your behalf, putting our data to work to determine the right rates and taking a transparent, tech-first approach to facilitate communication among all stakeholders.
Handling the Admin
With top-tier providers primed for the network, the final phase of network maintenance is nearly complete. If required, our team can prepare new HSD tables to Medicare specifications, ensuring that they are complete, compliant, and on time. andros makes this complicated process faster and error free.
Keeping Your Medicare Advantage Network Compliant
As CMS continues to closely monitor Medicare Advantage plans, health plans must maintain adequacy on all existing provider networks, or risk fines and penalties that can hinder their ability to succeed in the marketplace. MA plans that practice regular compliance monitoring eliminate the possibility of violating CMS Adequacy rules. Additionally, these plans improve member satisfaction, protect Star Ratings, enhance provider engagement, and improve their overall market position.
Talk to Us
Find Out How We Can Help Maintain Your Provider Network
Network compliance is a major step in ensuring the future success of your plan, and it’s a step we take seriously. Schedule some time today to speak to one of our experts, and we’ll walk you through what we can do to keep your ecosystem healthy and thriving.
Find Out How We Can Help
Our suite of services is designed to adapt to your needs. For any step in your provider network management process, we have a solution to help your team achieve greatness. Schedule some time with an andros expert today and find out what we can do for you.