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Avoiding Adequacy Surprises: Building a Real-Time Monitoring Workflow

Presented by the Blueprint Network Team

Most adequacy failures are discovered at submission time — after months of contracting and credentialing work. In this session, we walk through how to build a real-time adequacy monitoring workflow that catches gaps weekly, not once. We'll cover: which data sources to track, how to set gap thresholds by county and specialty, when to trigger escalation campaigns, and how to manage exception filings proactively.

• Which data sources to track for real-time adequacy monitoring
• How to set gap thresholds by county and specialty
• When to trigger escalation campaigns
• How to manage exception filings proactively