There are many factors employers consider when selecting an insurance carrier: price, benefits, service reputation and, to an increasing level of scrutiny, provider network. Positioning your provider network as the best fit for a client or prospect can make all the difference in winning the business.
Provider networks have to satisfy customers and members on multiple levels:
- Wide range of choices: multiple general and specialty providers are included in the network
- Convenient to use: providers are located near home or work
- Include popular providers and facilities: providers are the ones that members and their families want to use
- Cost-effective: in-network providers offer meaningful discounts that reduce out-of-pocket expenses and claim costs
Because the provider network is hard to measure and so important to winning and retaining business, the industry has developed four types of network analysis:
- Network Counting – measure the quantity of providers in each network
- Accessibility Analysis – correlate network provider locations to employee home and work locations
- Disruption Reporting – match historical provider utilization and claims experience for a group to the providers in a different network
- Repricing – compare cost of claims for all providers (in- and out-of-network) if a different network were in place to the cost experienced in the current network
Insurance companies and network leasing partners are both the source of the data in these reports and the consumers of the analyses during their sales processes. This dual role provides incentive to invest the resources needed to prepare and maintain network data so that they are in the best position to win new business.
So, what can you do to show your network in the strongest position?
Here are five best practices for managing your network data that will give you the best results in your network comparisons.
- Review your directory data regularly. Be sure that provider names, addresses, and phone numbers are up to date. Transparency in your reporting will be to your advantage in the long run.
- Check for duplicate records that can be consolidated, especially if you are stacking networks, since it can be hard to identify providers from the vendor network that are already in the carrier network.
- Adopt data standardization practices, particularly for numeric fields. For example, make sure leading zeroes on ZIP codes have not been dropped and replaced by the first digit of the ZIP+4. This is common in ZIP codes in New England, New Jersey, and US Caribbean territories.
- Consider including competitor network data in your analyses so that you understand your competitive position, predict results, and prepare for the future.
- For Disruption Reporting and Repricing, make sure that provider name data is properly parsed and address data is standardized. Use the same processes for claim and provider data files to give best chance of identifying valid matches.
Earning new business and retaining current customers are the lifeblood of every company. Improving your position by cleaning and maintaining your network data can make it easier to do both.
What process do you use today to manage your network data?