The compliance verdict, computed the way the regulator computes it — and the network behind it, managed as an asset.
Network sufficiency is the rare analytic with a right answer: either your members can reach each specialty within the standard, or they can’t, and an auditor can ask you to prove it member by member. Most plans rent that answer once a year. It should be a standing capability — and the same data should tell you who is actually in the network, what they’re doing, and what it costs you.
The regulator’s geography, not a proxy for it
Compliance is scored against the federal beneficiary geography the regulator actually uses — the real sample population, independent of who is enrolled with you — and, separately, against your own members at their rooftop addresses. Those two lenses answer different questions: one is your compliance posture, the other is your members’ real access.
Both run on the same engine. Neither is a reconstruction of the other, and the platform never quietly substitutes one for the other.
Real drive time, which is stricter
Straight-line distance understates driving distance, and near a threshold that difference flips a verdict. Alberto resolves the clear passes and clear failures deterministically and applies real road routing to the genuinely marginal cases. The accuracy of our engine is unparalleled, and we stand behind every verdict it produces.
Real routing reveals more deficiencies than an estimate does. That is the correct behavior. A compliance tool that clears you is worth nothing; one that finds what an auditor would find is worth the contract.
Credits applied the way the rule writes them
Threshold reductions, designation-based standards, certificate-of-need credits, telehealth credit where it is actually evidenced — the verdict matches the regulator’s own credit logic, including the cases where a credit is available but the supporting data isn’t in the feed yet. Where an assumption is doing work, the artifact labels it as an assumption and never lets it into a compliance verdict.
Every gap ships with who to call
A failing specialty comes with ranked candidates who aren’t in your network yet — individual clinicians and facility organizations, sourced from public registries and federal facility files, distance-ranked and scored by how much of the gap a single contract would close.
And a picture: the county with its boundaries and postal areas drawn, failing areas shaded, your existing network plotted, candidates sized by leverage.
Provider network analysis — the network as a managed asset
Sufficiency answers whether the network is big enough. It doesn’t answer whether it’s the right network, and that is the more expensive question.
Provider scorecards. Documentation quality against the conditions each panel actually carries, coding patterns that look like templates rather than medicine, and the gap between what a provider documented and what was credited — the picture you should have before someone else presents it as a finding.
Roster reconciliation. What a group says it has, what’s credentialed, what’s contracted, what’s actually billing — reconciled, with the ghosts, the overstatements and the terminations nobody recorded named specifically.
Directory accuracy. The directory the regulator holds you to, generated from the same credentialed source as the sufficiency analysis, so the two cannot disagree.
Termination impact. Before a provider leaves the network, which members lose access within the standard, and which don’t.
The offer
Let us analyze any county in your credentialed network — a complete sufficiency analysis with member-level evidence, the maps and the remediation steps, fixed fee, delivered in roughly one week.
Then put it next to the report you paid for this year. That comparison is the entire sales process, and we are content to lose it on the merits.
Every artifact carries a self-documenting guide to its own worksheets and columns, a member-level access audit, and a tier of integrity assertions that prove the inputs before the scorecard is believed. Submission tables are generated from the same credentialed source as the analysis, so what you file and what you analyzed cannot disagree.
One county. One week. Then put it next to the report you paid for this year.