NADP Knowledge Center
It Takes Two to Tango – Directory and Claims Data (2019)
Recorded On: 11/14/2019
It’s not a secret that dental directories overstate access across the industry - network size is a key metric for consultants, employer groups, and other plan sponsors. However, customer and regulatory pressure to clean directory data up is increasing. The challenge to present an accurate directory view is complicated by the need to pay claims for services provided by in-network dentists at non-primary locations. It’s daunting to take the plunge and risk your market share. Join us to hear how to address this complicated initiative and learn ways to use data to right-size your provider directory while maintaining your market presence.
Topics to explore include:
How consumer complaints and studies have led to increased regulation around accuracy
Challenges in solving this issue including network growth trends
Differentiating between provider directory and claims data
Comprehensive approach to cost-efficient directory accuracy
Laura Kravet McMullen
Director, Client Engagement at Zelis Healthcare
Laura McMullen has significant experience in diverse aspects of the healthcare industry. She has provided marketing and communications expertise at Cigna Dental, National Healing Corporation, and the University of Miami Sylvester Comprehensive Cancer Center. As Director of Client Engagement for Zelis Network Analytics, she draws on her industry knowledge to help customers leverage network analytics to drive business results. Educated at Nova Southeastern University and the University of Florida, Laura currently serves on the Education Commission for the National Association of Dental Plans, keeping her ear to the industry’s trends and needs.
Sales Executive, Zelis Healthcare
Jimmy joined Zelis in 2014 and is part of the sales and business development team at Zelis Network Analytics. He is responsible for all sales efforts with new prospects and existing accounts. These efforts include the Network360 analytics suite, Provider Data Accuracy and Network Builder and Optimizer projects as well as client-customized deliverables.
Most recently before joining Zelis, Jimmy worked for Quest Diagnostics as a Senior Account Manager. Jimmy has over 10 years of sales experience as well as, operations, project management and consulting,
Jimmy graduated from the University of Kansas with a degree in Community Health.