Provider Verification
Keep your provider directory compliant, accurate, and audit-ready
Take the pressure off your team with a proven, audit-ready process that ensures accuracy, supports accreditation, and improves provider directory data at scale.
Strengthen networks with confidence
Stay NCQA and CMS compliant
Support NCQA Standard NET 5, Element C, and CMS quarterly validation requirements for Medicare plans. Meet all mandated elements using valid and defensible survey methodology.
- Satisfy accreditation and regulatory obligations.
- Choose from monthly, quarterly, or annual cadence.
- Validate across specialties with statistically sound samples.
What makes Provider Verification at Press Ganey different?
Audit-ready reporting
Receive all NCQA and CMS-required documentation, including corrected data files, executive summaries, and raw data outputs.
Flexible outreach methods
Primarily phone-based, with optional IVR, email, or fax outreach based on your provider population and goals.
Tailored quota sampling
Our team builds statistically valid samples based on your specialties, regions, and lines of business.
Turnkey project management
Our dedicated project managers and analysts handle everything for you.
Get your questions answered
What provider data do we need to supply?
You’ll need to send a current export of your provider directory, including any fields you want validated—location, phone, hospital affiliations, etc.
How do you contact provider offices?
Our agents usually contact them by phone, calling during weekday business hours, excluding lunch hours. We can also use IVR, email, or fax if you need us to.
Can this be run quarterly or monthly?
Yes. We offer flexible administration options—monthly, quarterly, or annually—to match CMS or NCQA deadlines and your audit schedule.
Can this be bundled with Provider Satisfaction surveys?
It is possible. But we recommend running Provider Verification on its own to keep the survey short and ensure full accuracy review.
A health plan suite, built on insights and action
Member Journey
Capture member feedback in the moments that matter and get real-time insights into how to fix pain points, deliver seamless, personalized experience, and close the loop quickly.
Net Promoter Score
Get a reliable view of member loyalty to measure, analyze, and improve loyalty and experience in one program.
Medicare CAHPS
Ensure regulatory compliance—from sample validation to survey administration and reporting—while unlocking insights that directly impact member experience.
Health Outcomes Survey
Capture Medicare Advantage members’ reports of their physical and mental health over time.
Stars Monitor
Understand the complexity of Stars math and the results of CMS changes.
Predictive Analytics
See beyond survey results and model satisfaction, disenrollment risk, and key CAHPS measures at the member level.
Behavioral Health (OPMH)
Get actionable insights into outpatient mental health and substance-use services, including telehealth—so you can close gaps, strengthen access, and drive meaningful outcomes.
Case Management
Capture direct member feedback and get insights into communication, helpfulness, access, and health outcomes.
Tailored insights. Trusted results.
