3 Common Questions About Disruption Reports

By Tim Fitzgerald on Jul 13, 2020 3:00:00 PM

When employers switch insurance carriers, one of the key things to consider is the network. Employers want to ensure their employees can still see their current doctors and dentists. It can be frustrating for employees if their favorite dentist is no longer covered. This is where disruption reports help. They show which providers are available with each new carrier, helping avoid surprises. Here are some common questions about disruption reports and tips to help you choose the best carriers for your clients.

What is a disruption report?

A disruption report, as explained by NetMinder, is a way to analyze networks. It compares the past use of providers and claims by a group of employees to those in a new network. Brokers use these reports to see which carriers have most of the providers that employees already use. Even if a carrier has a good network, employees will be unhappy if they have to find new dentists to get coverage. The disruption report lists the most used providers, which the carrier checks against their networks to see how many employees will be affected by switching networks. For more details on disruption reports, you can download NetMinder’s whitepaper on the topic.

How are the top utilized providers identified?

The easiest way to find a group’s top providers is by checking their claims history. The providers with the most claims will be on your top utilized providers list. It’s that simple! If your client wants a more detailed list, you can also see which providers treated the most patients, performed the most procedures, or had the most paid claims.

How do you best evaluate disruption reports?

Evaluating a disruption report is straightforward—just find out which carriers have the most frequently used providers in their networks. However, analyzing these reports can be a bit more complex. Here are some helpful tips for analyzing disruption reports:

Think about any proposed network discounts – in-network discounts aren’t a selling point if most employees’ providers are out-of-network.
Keep geography in mind – highly utilized providers in rural areas are especially important. There might not be many alternatives for employees in a rural area.
Be aware of the network structure – is this an HMO or PPO network? The disruption may be more important for employees who select the HMO, since they don’t have the option to see a provider out-of-network and still be covered.

With a bit of preparation and knowing what to look for, disruption reports can be very helpful. They are simple and provide the network information you need to assist your clients in making the right choices.