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May 4, 2016 7:35 AM ET

Archived: MedicalQuest addresses regulatory compliance issues in hospitals, health plans and health systems by delivering accurate healthcare provider data in real time.

iCrowdNewswire - May 4, 2016

Medical Quest, Inc

Denver, CO 80203, US

MedicalQuest addresses regulatory compliance issues in hospitals, health plans and health systems by delivering accurate healthcare provider data in real time. New federal and state regulations regarding provider data accuracy are driving demand.

Accurate provider information is central to every aspect of healthcare delivery from an initial referral to payment of the final claim. In the US, there is no central, reliable source for tracking providers.

Healthcare organizations looking to stay viable and competitive must identify ways to maintain this data accurately and derive more meaningful and real-time business knowledge from it. Systems need to be coordinated, accountable and drive profits. Our customers want to increase efficiency, limit unnecessary errors, avoid duplication and save money. Medical Quest addresses these needs with our core product set.

Additionally, new regulations targeting inaccurate provider data are driving demand for our solutions. The Centers for Medicare and Medicaid Services can fine insurers up to $25,000 per beneficiary for errors in plan directories, and many states have taken up this issue as well. California’s SB137 may serve as a model for many other states, driving increased demand for provider data management.

Products / Services

Healthcare Reference Data Management (HRDM) Platform

Healthcare Reference Data Management (HRDM) is a comprehensive, unified process and toolset that ensures consistency, uniformity, and accuracy across all critical data assets. Our proprietary process utilizes cross-correlation among a large number of sources to develop a data quality index.

We minimize the potential for human error contaminating data by automating the process. Seamless data cleansing and enrichment, regardless of source and format, ensures a consistent and accurate view of data from every interaction point. Data elements can be automatically inserted and updated regularly. Data can then be used either within the Medical Quest H-Cubed Platform or exported to other systems on-demand or via automated schedule.

H-Cubed Data Platform

The Medical Quest H-Cubed platform removes complex data obstacles by creating an organization-centric framework and providing precise, but easy to use, information sharing controls. H-Cubed is focused on the three essential aspects of information quality and delivery:

Data Integrity: The H-Cubed Integrity process identifies duplicate contacts and validates each record as needed. We classify stale or invalid contacts and identify which records are missing key data elements.

Data Integration: H-Cubed Integration represents a broad category of tools and processes designed to facilitate and automate the extraction and integration of data from various sources.

Data Intelligence: As competition increases and business becomes more challenging, we provide a way to stay agile and gather actionable intelligence. This means having the right data in the right place in real time. Our advanced analytics applications provide the insights that allow accelerated and confident decision making.

Provider Database

Medical Quest delivers accurate information on healthcare providers in real time, providing a trusted source for staying on top of the changing provider landscape.

While tracking healthcare providers may sound easy, the Wall Street Journal states that 24% of physicians change some attribute of their practice each year. It is time-consuming and expensive for healthcare organizations to stay on top of these changes.

Medical Quest has been addressing this challenge for over 20 years with our searchable provider database. We take data from multiple and varied sources and validate the data quality as we continually update our data. Discrepancies are researched and records updated daily to ensure we have the most accurate data.

We offer access to our database on a subscription basis to a wide range of healthcare organizations. Customers include hospitals, health systems, academic medical centers, and health plans and health agencies.

Provider Directory Solutions

This powerful, scalable environment allows customers to enable effective provider data governance by rapidly creating and efficiently maintaining a single view of their core provider directories.

Our platform manages the latest provider data information in real time by layering our process onto a customer’s data, resulting in better, more accurate data.

Data is systematically collected, analyzed, validated and published. Providing the most comprehensive, accurate, and current provider information. Directories can be published real-time via web interface, downloaded into an electronic format or produced as a hard copy directory.

Regulatory Compliance

Healthcare organizations now face large fines for inaccuracies in provider directories. From state regulators to the Centers for Medicare and Medicaid Services, the fines being levied are real and can reach into the millions. In California alone, health plans were hit with massive fines and forced to refund over $38 million in claims. Medical Quest brings peace of mind to our customers.

We can ensure customers have up-to-date information for all of their provider records. Contact Verification provides a profile and baseline, confirming which records are valid. During the contact verification processes, Medical Quest will identify duplicate contacts, and update or classify stale or invalid records. We will then identify which providers are missing key company-level data needed for segmentation, such as affiliations, office locations, or primary physical practicing address, and instantly update their profiles.

Geographic Provider Analytics

Having the ability to visualize provider data offers a unique perspective for business and strategic planning.

Physician Metrix is our proprietary custom mapping application offering:

A sophisticated drive-time algorithm that shows the distance between provider office locations and patient locations through map layers, making it easy to identify opportunities and make informed workforce planning decisions.

Advanced analytics to inform and direct a health system’s strategy. With demographics, competitive analysis, and medical staff analysis, Physician Metrix allows customers to readily illustrate where needs exits and efficiencies can be found.

Physician Metrix collects, correlates and presents users with a self-service reporting solution to make data-driven and evidence-based decisions. It is a very flexible and easy-to-use BI solution for users to produce visualizations, reports and dashboards.

Advanced Analytics and Business Intelligence

MedicalQuest offers several advanced analytics applications built on our core platform:

Provider Credentialing

Our custom credentialing application allows organizations to leverage the most accurate provider data available throughout the credentialing process. This integration allows for a significant improvement in the overall efficiency of the credentialing process.

Referral Analysis

Users can easily identify patterns in referral behavior, understand competitive threats to a specific market, and visually analyze referral streams using unique demographic coded strategic mapping technology.

Advanced Real-Time Analytics

Utilizing dozens of pre-designed templates, data is linked and dashboards are automatically refreshed as data is updated, allowing users to analyze, strategize and share insights in real-time. Every dashboard and info-graphic is easily shared in its native or PDF format so other stakeholders can analyze findings with intuitive segmentation tools.

Professional Services

Medical Quest provides Professional Services with Business Intelligence (BI) in mind. We provide comprehensive lifecycle data management services using the H-Cubed framework.

Services include:

Setting up Cleanse Mapping rules for data integrity, intelligence and integration
Building ETL processes
Installation and configuration of BI processes
Developing reporting and dashboard tools
Ongoing support of provider database environments

Training and support

Training of administrators
Training of end users
Support of managers in the change process and understanding of BI environment

Data manipulation

Data Design Problems analysis
Data Improvement
Data Retrieval and Conversion



Chief Executive Officer
John Gray

John has built and successfully managed international and domestic operations groups. He is an expert business leader in operations within the healthcare and communications industry, supporting large diverse organizations and providing operations services, sales, marketing and customer support to Enterprise and Carrier class customers throughout the U.S. and Europe.

Chief Technology Officer
Kevin Alcox

A results-oriented technology leader for more than 20 years employing hands-on engineering, leadership, critical thinking and operational skills to extract business value from technology. Recognized for ability to combine people, process and technology to solve business challenges with innovative solutions. Kevin holds a Bachelor’s Degree in Computer Engineering from Iowa State University.

Chief Financial Officer
Mark Soeth

Mark has a 25-year track record as a successful leader in financial and organizational management. Mark spent 10+ years working with healthcare organizations in the Bay Area, serving as the CFO for East Bay Medical Network and Sutter Pacific Medical Foundation. Mark holds a B.A in Economics from UCLA and an M.B.A. in Finance from St. Mary’s College.

Senior Vice President Research & Development
Michael Hodes

Entrepreneurial technical leader with over 20 years of experience in all facets of healthcare data, utilizing it to measure and affect change. Hands-on manager firmly planted in both data and business camps, who consistently delivers products and functionality on time and within budget. Solid understanding of the big picture in addition to the details and requirements to support it. 

Vice President Sales
John Spears

John has over 20 years of senior management, direct sales and strategic alliances experience in both venture-backed startup companies, three of which have been acquired, and large multinational companies including EMC and Information Builders. John has held several leadership positions within the tech industry and most recently was OEM Sales and Partner Manager at IBI. Graduate of the University of California at Los Angeles (UCLA).

Contact Information:

Chief Executive Officer - John Gray

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