Servicing Provider Report

The Servicing Provider Report contains one record for each provider in each county. Use cases for this data vary depending on your business logic. Two common use cases are:

Re-ingest the data back into your system to feed internal provider dashboards.
Analyze the “serves percent” field to understand provider coverage.

To get Servicing Provider Results, submit a GET request to the following endpoint. The request takes a projectId path parameter and an authorization token in the request body. For example:
```
GET /enterprise/proj-mgmt/v3/Projects/{{projectId}}//adequacy/results/servicing-providers HTTP/1.1
Host: https://uat-api.questanalytics.com
Authorization: Bearer {{accessToken}}
```
This response contains a data array which includes one element of the following form for each provider in each county:
```
{
   "ServicingState": "TN",
   "ServicingCountySSA": "44130",
   "ServicingCountyName": "Clay",
   "ServicingSpecialtyGroupCode": "S03",
   "ServicingSpecialtyGroup": "Primary Care",
   "NPI": "1811454077",
   "Name": "Aaron, Benjamin T.",
   "Phone": "",
   "Fax": "",
   "Address": "8401 Hwy 111",
   "Address2": "",
   "City": "Byrdstown",
   "State": "TN",
   "Zip": "38549",
   "CountySSA": "44680",
   "CountyName": "Pickett",
   "Latitude": 36573656,
   "Longitude": 85152618,
   "GeoInfo": "Address-Exact",
   "SpecialtyCode": "001",
   "Specialty": "General Practice",
   "MedicareCCN": "",
   "MedicareCertifiedBeds": "4",
   "Serves": 82.3,
   "AcceptsMedicareAssignment": "",
   "Prefix": "",
   "First": "",
   "Middle": "",
   "Last": "",
   "Suffix": "",
   "Credentials": "",
   "Gender": "",
   "Taxonomy": "207K00000X",
   "ContractType": "DS",
   "AcceptingNewPatients": "Y",
   "MedGroupAffiliation": "",
   "Quality": "",
   "UnderContract": "",
   "MedicareClaims": "",
   "MedicareClaimants": "",
   "IsNextClosestProvider": "",
   "NextClosestAverageDistance": "",
   "NextClosestIsServicing": "",
   "NextClosestMemberCount": "",
   "ReasonForExcludingNcp": "",
   "CommentNcp": "",
   "ExclusionVerifiedSourcesNcp": ""
}
```
The following list provides explanations for those fields in the response that are not self-explanatory:
- MedicareCCN: The Medicare Certification Number is a unique identifier for a Facility. No longer in direct use by CMS, but some plans still use this information.
- MedicareCertifiedBeds: Number of beds inside a hospital that have been certified by CMS.
- Serves: Percentage of members covered within time/distance at this location.
- AcceptsMedicareAssignment: Whether or not the provider/facility has accepted the Medicare reimbursement rate.
- ContractType: Medicare HSD field. DC = Direct Contract. DS = Downstream Contract.
- MedGroupAffiliation: Medicare HSD field. Name of the affiliated Medical Group, if any.
- Quality: Metric used to measure the Quality of a provider (this field typically uses client-identified data).
- UnderContract: Medicare HSD field. Does the health plan use the CMS Contract Amendment to contract with the provider? (Y or N)
- MedicareClaims: Dollar amount of Medicare Claims. Driven by CMS Claims data (2 years in arrears).
- MedicareClaimants: Number of Medicare Claims. Driven by CMS Claims data (2 years in arrears).
- IsNextClosestProvider: Must have exceptions package add-on purchased for this to show up. Indicates whether the provider is a next closest provider outside of time/distance for specialty exception purposes.
- NextClosestAverageDistance: This field is available only when client has purchased exceptions package add-on. Indicates the average distance to members if the Provider is a next closest provider outside of time and distance.
- NextClosestIsServicing: This field is available only when client has purchased exceptions package add-on. Indicates if the Provider is already within time/distance of other members (Y or N).
- NextClosestMemberCount: This field is available only when client has purchased exceptions package add-on. Indicates the number of members this provider is the closest to, outside of time and distance.
- ReasonForExcludingNcp: This field is available only when client has purchased exceptions package add-on. Indicates a reason if this provider was excluded (for example, Retired or Deceased).
- CommentNcp: This field is available only when client has purchased exceptions package add-on. Indicates user entered comments explaining why this provider was excluded.
- ExclusionVerifiedSourcesNcp: This field is available only when client has purchased exceptions package add-on. Indicates a list of Verified Sources where this excluded providers information was found.
- LetterOfIntent: Medicare HSD Field. Indicates whether or not the health plan is using a Letter of Intent with the provider on their HSD table, in lieu of a signed contract.
To analyze the potential impact of the provider’s quality on your business, evaluate the relationship between the Serves field and the Quality field. The serves field indicates the percent of the county served by the provider, as calculated by Quest Analytics based on the latitude and longitude of the provider’s office location. The Quality field contains the quality score, as determined by your internal metrics.

If a provider’s Quality score is high and the provider serves a large percentage of members in the county, negotiations with that provider should focus on financial incentives to retain the provider in the network .
If a provider’s Quality score is low and the provider serves a large percentage of members in the county, it could be difficult to sell plans to prospective members.
If a provider’s Quality score is low and the provider serves a small percentage of members in the county, you might consider removing that provider from the network to improve the overall quality rating.