Analytics ready data powering Ad-hoc reporting
The Customer had a requirement to Process several sources of claims data and join them with the Eligibility data to get Insights into Cost Summaries. The existing Data management process was very manual and error prone. There were several reporting needs for this data and the following Business use cases were needed to be delivered.
- Spend and Visit distribution by facility settings, speciality, procedure etc.
- Cost comparison and variations by facility settings
- Cost saving opportunities by procedure
The Customer had severe issues in scaling the existing solution and applying or Modifying Business rules.
D Cube Leveraged IRIS self-service wrangling tool to prepare analytics ready data for various ad hoc reports as well as customer cost management application. IRIS is used to
- Filter out redundant and invalid claims in D Cube standard structure created by consolidating claims and eligibility data from various Third-Party Administrators (TPAs)
- Define episode of care by grouping claims that overlaps over a time period
- Map episode level claims data with CPT master table and define procedures
- Match with master list and filter out relevant & required Revenue codes, DRG and modifiers associated with each procedure
- Aggregate cost by procedure, geography, network and plan type for cost comparison summary report
IRIS solution created the following impact.
- DDS IRIS Solution reduced the Data processing timeframe from weeks to less than 2 days.
- Additional Business rules were very easy to add and the time to market was extremely short.
- The Solution enabled the Analyst at the organization be more productive and leverage the power of Cloud.