QueBall

QueBall Nomination Management System

Prime Health has a core philosophy of giving our clients access to the providers of their choice instead of forcing them in to a pre-established network.

QueBall incorporates our state of the art technological capabilities, as well as our network development expertise. These tremendous resources at Prime are forged into a solution for those in the marketplace that would like to develop their own network or simply increase penetration of their current provider mix. Our customers identify provider targets for their individual needs and our systems help to analyze the needs all the way down to the bill level. This is the heart of QueBall. Internally we use QueBall, our proprietary system that manages the nomination and network development process for our preferred provider network. This gives us the ability to create a custom network based on the client's unique needs. QueBall allows provider nominations to be evaluated for appropriateness, verified for correctness of data, hierarchy by utilization importance, and solicited by our network development team, who works with the provider to establish a competitive discount to encourage client referrals.

To stay on top of the provider nomination process, QueBall assigns each provider to a National Network Development Executive and interacts with the staff to initiate the contracting process, as well as tracking the status (from initial contact to in-network or declined to join network). You’ll know exactly where your provider nominations stand. This is true customization at the customer’s network level. QueBall drives the nomination and contracting process and is an internal operation that is unique to Prime Health. QueBall can assist in building large state-wide provider networks, small local provider networks, or simply assist in increasing penetration in an area that you are focused on achieving even better coverage.

Top Network Development Strategies

Special relationships and stellar communication between Prime Health and our clients determine how we might go about developing the network for a given customer. Strong systems, clear workflows, and experienced provider contracting staff enable Prime Health to deliver this network development strategy that will save our customers significant dollars in time, dollars, and development resulting in a tailored network of providers that meets our customers' specific needs.