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.
Although our existing network is robust and national in
coverage, we understand that not all clients utilize the same
providers. Thus, Prime developed a technologically
advanced customization system named
By utilizing QueBall, our internal proprietary software system
that controls, manages and administers the nomination and network
development process for our network. This gives us the ability to
create a custom network based on the client's unique needs.
QueBall allows nominations to be evaluated for
appropriateness, verified for correctness of data, hierarchy by
utilization importance and solicited by fax, email or standard mail
while our provider contractors work with the provider to establish
competitive discounts. QueBall interacts with and
assigns efforts to provider contracting staff to initiate and
follow through with the contracting process. This is to ensure the
right providers are added to the network to meet the needs of our
clients. This is true customization at the 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 networks, small local
networks or simply assist in increasing penetration in an area that
is already above average to be even better covered.
QueBall incorporates our state of the art technological
capabilities, as well as our network development and provider
contracting 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. Special relationships and stellar
communication between us and our clients determine how we might go
about developing the network for a given customer.
Strong software systems, workflow and experienced
provider contracting staff enable Prime Health to deliver this
network development strategy that will save our customers
significant dollars in time and development resulting in a
tailored network of providers that meets our customers' specific