Provider Network

Is the plan accredited? By whom? At what level?
What percentage of primary care physicians accept new patients?
What percentage of participating providers are board certified?
Can the plan produce a list of participating physicians affiliated with a specific hospital?
Are any treatment programs or specialties carved out or subcontracted to other vendors? If so, how do these programs differ from the payer's program?
How are primary and specialty doctors paid? Are there financial incentives to modify physician behavior? Does quality assessment affect doctors' compensation?
If an employee's physician chooses to join the network, will the plan accept new providers? How long does it take a physician to be reviewed and added to the network? What kind of review is undertaken regarding physicians' backgrounds?
What is the plan's physician turnover rate? How many physicians have been involuntarily dismissed from the network?
How does the plan review quality on an ongoing basis?
What percentage of plan members disenroll from the plan each year? Can the plan estimate what percentage of these are voluntary disenrollments?