Abstract: A computerized system and method for analyzing medical network adequacy. The computerized system and method uses agency guidelines and location information to generate a report as to whether a network of health care service providers satisfies adequacy requirements or access parameters and further identifies why access parameters were not met according to specialty within a county. It further identifies potential health care service providers for addition to the network to improve the compliance of the network. The analysis extends beyond pass-fail compliance with access parameters as determined by a healthcare agency and quantifies the impact of the addition of a non-participating health care services provider to the network. Non-participating health care service providers may be identified in a list and further, rank ordered within the list so that the providers likely to have the greatest impact on the adequacy measure are listed first.

Abstract: A computerized system and method for generating CMS-compliant health services delivery (HSD) tables. A database stores health care service provider data. A remote computer user interacts with a server that provides access to the health care service provider data. A user can view health care service provider data that meets selected search parameters. The data is displayed in an interactive worksheet. The user may further cause amendments to be made to the data stored in the database. The user may issue a request to generate an HSD table in “final file format” which conforms to CMS requirements. The server checks for errors in the file and notifies the user of errors that are identified. The server optionally checks for adequacy of the network associated with a plurality of health care service providers. The user may approve the final files for filing with CMS.

Abstract: A computerized system and method for generating CMS-compliant health services delivery (HSD) tables. A database stores health care service provider data. A remote computer user interacts with a server that provides access to the health care service provider data. A user can view health care service provider data that meets selected search parameters. The data is displayed in an interactive worksheet. The user may further cause amendments to be made to the data stored in the database. The user may issue a request to generate an HSD table in “final file format” which conforms to CMS requirements. The server checks for errors in the file and notifies the user of errors that are identified. The server optionally checks for adequacy of the network associated with a plurality of health care service providers. The user may approve the final files for filing with CMS.