National & Regional Networks
Access established PPO, EPO, and specialty networks spanning all 50 states — plus regional networks for markets where local depth wins the account.
Carrier Solution
Provider Network Access
Plug your health and benefits products into established national and regional provider networks — with credentialed directories, adequacy reporting, and member-facing provider search included, instead of negotiating one contract at a time.
Network Access
Established networks, ready to attach to your products
Medical, Dental & Vision
Connect products across lines of coverage — medical, dental, vision, behavioral health, and ancillary benefits — through one network access point.
Credentialing Data Feeds
Provider directories arrive with current credentialing status, board certifications, and sanction checks, refreshed continuously from primary sources.
Network Adequacy Reporting
Time-and-distance and provider-ratio analyses generate automatically by county and specialty, formatted for state and federal regulatory filings.
Member Provider Search
Embed accurate, plan-aware provider search into your member portal and mobile experience — with directory data that matches your filed networks.
Telehealth & Virtual Care
Extend networks with telehealth and virtual-first care options that satisfy access requirements in rural counties and round out plan designs.
How It Works
From network selection to live directories in four steps
Select networks by market
Choose national and regional networks by line of coverage, service area, and plan design — with coverage maps and provider counts to compare before you commit.
Attach networks to products
Map each product to its network configuration — in-network tiers, out-of-network rules, and telehealth extensions — directly on your exchange listings.
Validate adequacy for filings
Run time-and-distance and provider-ratio analyses by county and specialty, and export filing-ready adequacy reports for every state you operate in.
Go live with synced directories
Launch with provider directories, credentialing feeds, and member search synchronized — and continuously refreshed as networks change.
Network Adequacy
Adequacy reporting that keeps filings ahead of regulators
Network adequacy is monitored continuously, not assembled at filing time. As providers join or leave a network, adequacy metrics recalculate automatically — and your team is alerted the moment a county or specialty approaches a threshold, with time to cure before it becomes a filing problem.
Explore Data & Analytics- Time-and-distance analysis by county, specialty, and plan type
- Provider-to-member ratio reporting against state standards
- Directory accuracy monitoring with primary-source verification
- Filing-ready adequacy exports for state and CMS submissions
- Gap alerts when network changes threaten adequacy thresholds
FAQ
Provider network questions, answered
Which lines of coverage can connect to provider networks?
Medical, dental, vision, behavioral health, and ancillary benefits products can all attach to networks through the exchange. Each product maps to its own network configuration, so a carrier can pair different networks with different plan designs.
Can we use our own contracted network alongside exchange networks?
Yes. Your proprietary network loads into the same directory and adequacy tooling, and products can blend your direct contracts with exchange network access — for example, using a leased network to fill rural or specialty gaps.
How current is the provider directory data?
Directory and credentialing feeds refresh continuously from primary sources, including NPI registries, state boards, and sanction lists. Changes in provider status, location, or panel acceptance propagate to member search and adequacy metrics automatically.
Does adequacy reporting satisfy state and CMS requirements?
Reports follow standard time-and-distance and provider-ratio methodologies and export in filing-ready formats for state DOI and CMS submissions. You can configure thresholds per state so alerts match the standards each regulator applies.
Can members search providers from our own portal and app?
Yes. Plan-aware provider search embeds into your member portal and mobile experience through the exchange API, so members always search the directory that matches their actual filed network — not a generic national list.
Launch with networks already in place
Join Insurance Exchange and connect your health and benefits products to established provider networks — with directories, credentialing, and adequacy reporting built in.