Unlocking 4 Areas of Provider Network Value in the Wake of Surprise Billing Mandates


The No Surprises Act and Consolidated Appropriations Act have led to significant operational and transparency changes for payers. Provider network operations are now under pressure due to regulations, labor challenges, and inaccuracies in databases, affecting patient access to care and satisfaction levels. Health plans are rethinking their provider network operations and seeking management tools to improve accuracy, compliance, and cost savings. These tools need to address breakdowns, improve digital navigation, ensure interoperability, and enhance provider relationship management. Partnering with outside consultants can provide high-value solutions and improve outcomes for all stakeholders. The future of healthcare lies in innovative provider data management and collaborative focus on members and patients.

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