4.13 Top 30 Providers

The Top 30 Providers report lists the thirty most heavily utilized providers based on the total amount of sponsor dollars paid.

Claims review top providers

The bottom of the table includes a detailed summarization for the providers displayed. Additional provider information can be retrieved by clicking on "Show More".

Claims review top providers paging

**Note that clicking on a provider name drills down for further claim investigation. Please refer to the Drill Down section.

Helpful Hints:

Headers (Name, # Claims, Total Charge, Plan Paid, % Paid and % Usage) can be manipulated by clicking on the desired report header to create additional reporting outcomes.

To run a provider disruption report to evaluate/shop network performance or discounts, download to excel format by clicking on excel icon on the top of the screen.

The Provider report provides useful information when (re)negotiating network discounts.

Drill down provides top providers that fall outside a network. This will enable the provider to be identified for contract negotiations.

TPA can review report to see if an EPO type plan or smaller network, would work for employee population. Plans could be set up to select one hospital system over another.