Network Tiers

Four Levels of Excellence

Synora's tiered accreditation system rewards quality with cashless eligibility, preferred patient access, and performance bonuses.

๐Ÿ’Ž
Platinum
90โ€“100
Quality Score
โœ“Full cashless eligibility
โœ“Priority directory listing
โœ“+15% performance bonus
โœ“Premium employer plans
โœ“Dedicated account manager
18% of network
๐Ÿฅ‡
Gold
80โ€“89
Quality Score
โœ“Full cashless eligibility
โœ“Enhanced directory listing
โœ“+8% performance bonus
โœ“Standard employer plans
โœ“Quarterly review calls
34% of network
๐Ÿฅˆ
Silver
70โ€“79
Quality Score
โœ“Partial cashless eligibility
โœ“Standard directory listing
โœ“Improvement support
โœ“Basic employer plans
โœ“Semi-annual review
31% of network
๐Ÿฅ‰
Bronze
60โ€“69
Quality Score
โœ“Reimbursement only
โœ“Basic directory listing
โœ“Improvement program
!90-day improvement plan
!Risk of de-listing
17% of network
Scoring Framework

Six Dimensions of Quality

Each dimension is weighted to reflect its clinical and operational importance. Scores are updated quarterly based on data collected from claims, audits, and patient feedback.

๐Ÿ“‹
Weight
20%

Licensing Compliance

Valid operating license, current professional registrations, and mandatory insurance certificates โ€” all verified annually with MoH and regional health bureaus.

Assessed by
Document AuditMoH Verification
๐Ÿฉบ
Weight
25%

Clinical Quality

Treatment outcome reporting, clinical protocol adherence, adverse event documentation, and infection control standards. Assessed via clinical audits and chart reviews.

Assessed by
Clinical AuditOutcome Data
โœ…
Weight
20%

Claims Accuracy

Error-free submission rate, correct ICD-10 coding, complete documentation, and timely submission within the 30-day window. Scored per quarter from claims data.

Assessed by
Claims DataCoding Review
โญ
Weight
15%

Patient Satisfaction

Post-visit patient feedback collected via SMS survey (5-point scale) and anonymous digital ratings in the Synora member app. Minimum 40 responses required per quarter.

Assessed by
SMS SurveyApp Ratings
๐Ÿ”€
Weight
10%

Referral Management

Appropriate and documented specialist referrals, timely referral letters, and evidence of follow-up care coordination. Assessed from referral claims and discharge records.

Assessed by
Referral ClaimsDocumentation
๐Ÿ“„
Weight
10%

Documentation Quality

Completeness, legibility, and timeliness of medical records, discharge summaries, operative notes, and clinical correspondence. Assessed during scheduled record audits.

Assessed by
Record AuditCompleteness Check
Sample Scorecard

What Your Quality Report Looks Like

Every provider receives a quarterly quality scorecard through the portal with scores, benchmarks, and personalized improvement recommendations.

โ†’Current score vs. tier threshold
โ†’Score trend over 4 quarters
โ†’Comparison to peer benchmark
โ†’Improvement action items
โ†’Projected tier for next quarter
View My Scorecard
Quality Scorecard ยท Q1 2025
Bethzatha Generalโ˜… Gold
Overall Score
91/100
โ†‘ +4 from Q4 2024
91%
Licensing
98
Clinical Quality
87
Claims Accuracy
94
Patient Satisfaction
82
Referrals
89
Documentation
91
Next Tier: Platinum (90+)
Improve patient satisfaction by 8 points to qualify for Platinum in Q2 2025.
Get Started

Ready to Join and Build Your Quality Score?

Apply to the Synora Health Network and start building your quality profile from day one.

Apply to Join Network Provider Portal Login