Medicare

Network Development

Doral has significant experience in building fully-compliant networks for government programs. We currently contract with 11,800 unique providers nationwide at 21,300 access points. "Unique" means we recruited them specifically to serve the Medicaid, SCHIP, and Medicare populations. Doral's network is screened and contracted specifically for this purpose and this population.

Doral has processes to ensure that there are enough credentialed providers to treat our clients' members. In several cases, we have succeeded in doubling or tripling the size of existing provider networks in a short time to address the needs of our customers. In the state of Illinois, the network has more than doubled in size since Doral began administering its program, growing from approximately 800 providers to over 2000. And in Tennessee, provider participation has grown significantly under Doral's administration from approximately 400 to 750 dentists.

We measure network sufficiency each month and document all recruitment efforts using a state-of-the-art recruitment database. Through this database, we track all clients, contracts, and the current status of each prospective provider. Doral also targets existing network providers for increased participation to maximize capacity within any Doral network. These efforts all add up to one positive outcome: increased access to services for the populations we serve, and stable provider networks that members can count on to provide the services they need.

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