Network Excellence Vertical

Network Excellence

Own provider data quality, network adequacy, and referral performance from a single governed source of truth.

94%

Avg. accuracy after cleanup

Directory Accuracy

Audit provider data quality and eliminate ghost or duplicate providers.

40%

Faster gap detection

Network Adequacy

Measure access gaps by geography, specialty, and appointment availability.

$2.4M

Avg. annual savings

Leakage Control

Track referrals leaving the network and protect in-network utilization.

Network KPIs

Turn provider data quality into measurable access and compliance outcomes.

+8%

Directory Accuracy

95%+ verified data

+12%

Adequacy Coverage

Close access gaps

-18%

Leakage Rate

Reduce 10-25%

+15%

Provider Utilization

Increase in-network use

Data Foundation

Built on a first-party provider directory with real-time updates. Track every provider, location, and specialty across payers and provider networks.

FHIR Provider Directory (Practitioner, Organization, Location)
Claims & Referrals
Scheduling & Access
Network Contracts
Member Enrollment
Quality & Experience Signals

Enterprise Controls

  • Governance for provider data sources and update workflows.
  • Role-based access for provider ops, contracting, and compliance.
  • Audit-ready adequacy reporting with exportable evidence.

Core Capabilities

Focused modules that make provider network data trustworthy and actionable.

Directory Governance

Normalize and dedupe providers with golden records.

Access Gap Radar

Map coverage gaps by specialty and geography.

Leakage Tracking

Track in-network vs out-of-network referrals.

Network Readiness

Adequacy scorecards and compliance exports.

Visual Snapshot

A quick visual read of directory accuracy, access gaps, and leakage exposure.

Network Excellence Dashboard

Real-time network analytics

Live Data

Access Gaps by Specialty

Cardiology
8 counties
Dermatology
12 counties
Psychiatry
15 counties
Endocrinology
6 counties
Orthopedics
4 counties
Total flagged45 counties

Top Leakage Sources

Regional Medical Group
$340K
Metro Health Partners
$280K
Valley Specialists
$195K
Coastal Care Network
$156K

Directory Issues

Duplicate Providers
234In Review
Invalid NPIs
89Flagged
Stale Locations
167In Review
Missing Specialties
45Resolved
Resolution rate78% this month

Operational Playbooks

Launch with ready-made workflows for network integrity and growth.

Provider directory remediation with automated checks
High Impact
Access gap scoring by county, zip, and specialty
Critical
Referral leakage by provider and service line
High Impact
Network adequacy compliance reporting
Required

Visual Journey

A simple, visual path from provider data ingestion to adequacy outcomes.

1

Ingest & Normalize

Merge provider sources and enforce golden records.

2

Score & Detect

Surface adequacy gaps, leakage, and access issues.

3

Act & Report

Export compliance evidence and monitor improvements.

Why Network Teams Buy

Fix directory accuracy, protect access compliance, and stop network leakage.

Compliance Confidence

Adequacy evidence and directory governance ready for audits.

Access Performance

Identify coverage gaps by region and specialty in real time.

Leakage Control

Reduce out-of-network spend with referral tracking and analytics.

Make Network Performance a Competitive Advantage

Deploy faster than manual audits, with live visibility into access gaps and provider data health.

Ingest
Detect
Comply
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